Provider Demographics
NPI:1720099062
Name:CAPDEVILLE, ANNE R (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:R
Last Name:CAPDEVILLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:37 MCMURRAY RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15241-1632
Mailing Address - Country:US
Mailing Address - Phone:412-835-6322
Mailing Address - Fax:412-835-5430
Practice Address - Street 1:37 MCMURRAY RD
Practice Address - Street 2:SUITE 106
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15241-1632
Practice Address - Country:US
Practice Address - Phone:412-835-6322
Practice Address - Fax:412-835-5430
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD022770E2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAB34392Medicare UPIN
PACA50734Medicare ID - Type UnspecifiedMEDICARE