MEDICARE: DARBY ANNE CAPELLIN PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	C0009261	MD

General Provider Information

NPI Number	:	1497519920
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARBY ANNE CAPELLIN PA-C

Provider Business Mailing Address
First Line	:	1142 COVE RD APT 101
Second Line	:
City	:	ANNAPOLIS
State	:	MD
Zip	:	21403-5123
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8700 CENTRAL AVE STE 203
Second Line	:
City	:	HYATTSVILLE
State	:	MD
Zip	:	20785-4868
Country	:	US
Telephone Number	:	301-710-0455
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2024
Last Update Date	:	02/06/2024

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