Healthcare Provider Details

I. General information

NPI: 1760096473
Provider Name (Legal Business Name): CAPRICORN HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2020
Last Update Date: 02/02/2021
Certification Date: 02/02/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 CHESAPEAKE BLVD SUITE B
ELKTON MD
21921-2192
US

IV. Provider business mailing address

101 CHESAPEAKE BLVD SUITE B
ELKTON MD
21921
US

V. Phone/Fax

Practice location:
  • Phone: 410-398-0590
  • Fax:
Mailing address:
  • Phone: 410-398-0590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. CHRISTOPHER E GELMANN
Title or Position: MANAGING MEMBER
Credential: MD
Phone: 443-553-0057