Provider Demographics
NPI:1629028857
Name:CAPPS, BRIAN A (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:A
Last Name:CAPPS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 E SUPERIOR ST STE 205
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55802-2196
Mailing Address - Country:US
Mailing Address - Phone:218-249-4300
Mailing Address - Fax:218-249-4350
Practice Address - Street 1:26 E SUPERIOR ST STE 205
Practice Address - Street 2:
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55802-2196
Practice Address - Country:US
Practice Address - Phone:218-249-4300
Practice Address - Fax:218-249-4350
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN43614207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI34408100Medicaid
WI34408100Medicaid
WIH41145Medicare UPIN