Provider Demographics
NPI:1598804957
Name:NICHOLAS CAPOZZOLI & PETER SCHILDER, MD, PA
Entity Type:Organization
Organization Name:NICHOLAS CAPOZZOLI & PETER SCHILDER, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:A
Authorized Official - Last Name:CAPOZZOLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-263-9490
Mailing Address - Street 1:122 DEFENSE HWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7069
Mailing Address - Country:US
Mailing Address - Phone:410-263-9490
Mailing Address - Fax:410-263-9593
Practice Address - Street 1:122 DEFENSE HWY
Practice Address - Street 2:SUITE 100
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7069
Practice Address - Country:US
Practice Address - Phone:410-263-9490
Practice Address - Fax:410-263-9593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDOO1668O2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCE2380001OtherCAREFIRST BLUE SHIELD
MDLL23NIOtherCAREFIRST BLUE SHIELD
MDLL23NIOtherCAREFIRST BLUE SHIELD
MD771L773DMedicare ID - Type UnspecifiedMEDICARE NUMBER