Basic Information
| Provider Information | |||||||||
| NPI: | 1194702928 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CAPPELLI | ||||||||
| FirstName: | MICHAEL | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1400 AFFLINK PL STE 101 | ||||||||
| Address2: | |||||||||
| City: | TUSCALOOSA | ||||||||
| State: | AL | ||||||||
| PostalCode: | 354062452 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2053669740 | ||||||||
| FaxNumber: | 2053449992 | ||||||||
| Practice Location | |||||||||
| Address1: | 105 US HIGHWAY 80 E | ||||||||
| Address2: | |||||||||
| City: | DEMOPOLIS | ||||||||
| State: | AL | ||||||||
| PostalCode: | 367323605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3342872647 | ||||||||
| FaxNumber: | 3342872405 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/22/2005 | ||||||||
| LastUpdateDate: | 04/26/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/26/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0001X | M5658 | TX | N | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology | 2085R0001X | 4301056847 | MI | N | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology | 2085R0001X | 40648 | AL | Y | Allopathic & Osteopathic Physicians | Radiology | Radiation Oncology |
No ID Information.