Healthcare Provider Details

I. General information

NPI: 1578665444
Provider Name (Legal Business Name): DONNA MICHELLE CAPPS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2006
Last Update Date: 05/06/2021
Certification Date: 05/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N ENGLEWOOD DR
KENLY NC
27542-9290
US

IV. Provider business mailing address

2000 PERIMETER PARK DR STE 200
MORRISVILLE NC
27560-8442
US

V. Phone/Fax

Practice location:
  • Phone: 919-284-4149
  • Fax: 919-284-6008
Mailing address:
  • Phone: 984-215-4110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number200101317
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: