Healthcare Provider Details

I. General information

NPI: 1194091488
Provider Name (Legal Business Name): GIACOMO LUIS CAPPELLETI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: GIACOMO L CAPPELLETI

II. Dates (important events)

Enumeration Date: 03/30/2012
Last Update Date: 07/09/2024
Certification Date: 07/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

844 KEMPSVILLE RD STE 104
NORFOLK VA
23502-3927
US

IV. Provider business mailing address

844 KEMPSVILLE RD STE 104
NORFOLK VA
23502-3927
US

V. Phone/Fax

Practice location:
  • Phone: 757-252-5600
  • Fax:
Mailing address:
  • Phone: 757-252-5600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License NumberME135391
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number0101276610
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: