Provider Demographics
NPI:1780871343
Name:KAPETANSKY, STEVEN DAN (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:DAN
Last Name:KAPETANSKY
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:PO BOX 536
Mailing Address - Street 2:
Mailing Address - City:GRANVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43023-0536
Mailing Address - Country:US
Mailing Address - Phone:740-808-8368
Mailing Address - Fax:415-548-2694
Practice Address - Street 1:1566 MONMOUTH DR STE 101
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-8048
Practice Address - Country:US
Practice Address - Phone:740-808-8368
Practice Address - Fax:415-548-2694
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-27
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.098573207P00000X
OH35098573207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0083484Medicaid
OHH183174OtherMEDICARE