=====================================================
General NPI Number Information
=====================================================
NPI Number | 1467553495
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANDREW PETER CAP MD, PHD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/25/2006
-----------------------------------------------------
Last Update Date | 02/06/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | MILE 187 GLENN HIGHWAY
-----------------------------------------------------
City | GLENNALLEN
-----------------------------------------------------
State | AK
-----------------------------------------------------
Zip | 99588-0589
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 907-822-3203
-----------------------------------------------------
Fax | 907-822-5805
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 5
-----------------------------------------------------
City | GLENNALLEN
-----------------------------------------------------
State | AK
-----------------------------------------------------
Zip | 99588-0589
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 907-822-3203
-----------------------------------------------------
Fax | 907-822-5805
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RH0003X
-----------------------------------------------------
Taxonomy Name | Hematology & Oncology Physician
-----------------------------------------------------
License Number | MD426844
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | 229536
-----------------------------------------------------
License Number State | AK
-----------------------------------------------------