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General NPI Number Information
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NPI Number | 1275584872
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Entity Type | Individual
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Provider Name | SUSAN C CAPELLE M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 06/05/2017
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Provider Practice Location Address
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Address Line | 3496 UNIVERSITY AVE
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City | MORGANTOWN
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State | WV
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Zip | 26505-3001
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Country | US
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Telephone | 304-599-7075
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Fax | 304-581-6800
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Provider Business Mailing Address
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Address Line | 3496 UNIVERSITY AVE
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City | MORGANTOWN
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State | WV
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Zip | 26505-3001
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Country | US
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Telephone | 304-599-7075
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Fax | 304-581-6800
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 20147
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 207VF0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
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License Number | 20147
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License Number State | WV
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Taxonomy #3
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Taxonomy Code | 2088F0040X
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Taxonomy Name | Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
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License Number | 20147
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License Number State | WV
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