Provider Demographics
NPI:1447573266
Name:KAPELKE, PETER LOUIS (BA,BS,CPO)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:LOUIS
Last Name:KAPELKE
Suffix:
Gender:M
Credentials:BA,BS,CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:FAIRFAX RD. @ VIRGINIA ST.
Mailing Address - Street 2:SHRINERS HOSPITAL SALT LAKE CITY
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84103
Mailing Address - Country:US
Mailing Address - Phone:801-536-3500
Mailing Address - Fax:
Practice Address - Street 1:FAIRFAX RD. @ VIRGINIA ST.
Practice Address - Street 2:SHRINERS HOSPITAL SALT LAKE CITY
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84103
Practice Address - Country:US
Practice Address - Phone:801-536-3500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-08
Last Update Date:2010-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist