Provider Demographics
NPI:1265409346
Name:CAPALAD, ELPIDIO (MD)
Entity type:Individual
Prefix:DR
First Name:ELPIDIO
Middle Name:
Last Name:CAPALAD
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 1:96 15TH ST NW
Mailing Address - Street 2:SUITE 104
Mailing Address - City:NORTON
Mailing Address - State:VA
Mailing Address - Zip Code:24273-1620
Mailing Address - Country:US
Mailing Address - Phone:276-679-8890
Mailing Address - Fax:276-679-9740
Practice Address - Street 1:100 15TH ST NW
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:VA
Practice Address - Zip Code:24273-1616
Practice Address - Country:US
Practice Address - Phone:276-679-9645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-07
Last Update Date:2011-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101023802207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005647967Medicaid
KY64661127Medicaid
NC7617257Medicaid
010001282Medicare ID - Type Unspecified
VAVAA104645Medicare PIN
VA005647967Medicaid