Healthcare Provider Details
I. General information
NPI: 1720065766
Provider Name (Legal Business Name): PETE CAPLES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/30/2005
Last Update Date: 11/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10506 MONTGOMERY RD SUITE 504
CINCINNATI OH
45242-4487
US
IV. Provider business mailing address
237 WILLIAM HOWARD TAFT RD 2ND FLOOR, CBO 2-3
CINCINNATI OH
45219-2610
US
V. Phone/Fax
- Phone: 513-792-7800
- Fax: 513-792-7807
- Phone: 513-792-7800
- Fax: 513-792-7807
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | 35039198 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: