Healthcare Provider Details

I. General information

NPI: 1467553495
Provider Name (Legal Business Name): ANDREW PETER CAP MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 02/06/2025
Certification Date: 02/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MILE 187 GLENN HIGHWAY
GLENNALLEN AK
99588-0589
US

IV. Provider business mailing address

PO BOX 5
GLENNALLEN AK
99588-0589
US

V. Phone/Fax

Practice location:
  • Phone: 907-822-3203
  • Fax: 907-822-5805
Mailing address:
  • Phone: 907-822-3203
  • Fax: 907-822-5805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberMD426844
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number229536
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: