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NPI Code Detail

MEDICARE: ANNA KAPUSTINA DPM

MEDICARE: ANNA KAPUSTINA DPM
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
1213EP1101XPrimary Podiatric Medicine PodiatristPOD-001135AZ

General Provider Information

NPI Number : 1629728522
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANNA KAPUSTINA DPM
Provider Business Mailing Address
First Line : 2730 S VAL VISTA DR STE 187
Second Line :
City : GILBERT
State : AZ
Zip : 85295-1684
Country : US
Telephone Number : 480-744-8827
Fax Number : 480-409-8545
Provider Business Practice Location Address
First Line : 2730 S VAL VISTA DR STE 187
Second Line :
City : GILBERT
State : AZ
Zip : 85295-1684
Country : US
Telephone Number : 480-744-8827
Fax Number : 480-409-8545
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2022
Last Update Date : 12/15/2025

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