Provider Demographics
NPI:1942491931
Name:BOYER, CANDICE CAPSTICK (DO)
Entity Type:Individual
Prefix:DR
First Name:CANDICE
Middle Name:CAPSTICK
Last Name:BOYER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:CANDICE
Other - Middle Name:ELIZABETH
Other - Last Name:BOYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:162 UPPER VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANA
Mailing Address - State:PA
Mailing Address - Zip Code:17509-9771
Mailing Address - Country:US
Mailing Address - Phone:609-504-2534
Mailing Address - Fax:609-228-2872
Practice Address - Street 1:162 UPPER VALLEY RD
Practice Address - Street 2:
Practice Address - City:CHRISTIANA
Practice Address - State:PA
Practice Address - Zip Code:17509-9771
Practice Address - Country:US
Practice Address - Phone:609-504-2534
Practice Address - Fax:609-228-2872
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-06
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB08351900204D00000X, 207R00000X
PAOS013565204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine