Provider Demographics
NPI:1407836299
Name:CAPONE, PATRICK M (MD)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:M
Last Name:CAPONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:125 MEDICAL CIR
Mailing Address - Street 2:SUITE A
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-3300
Mailing Address - Country:US
Mailing Address - Phone:540-667-1828
Mailing Address - Fax:540-722-3658
Practice Address - Street 1:125 MEDICAL CIR
Practice Address - Street 2:SUITE A
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-3300
Practice Address - Country:US
Practice Address - Phone:540-667-1828
Practice Address - Fax:540-722-3658
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VAN100204082084D0003X
VA01010489012084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084D0003XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyDiagnostic Neuroimaging
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA289217OtherANTHEM
VA130007966OtherRAILROAD MEDICARE
WV001717360OtherMOUNTAIN STATE BCBS
VA006124381Medicaid
WV0090116000Medicaid
VA130000451Medicare PIN
VA006124381Medicaid