Sergio Capuno Macatangay, MD

Individual provider Active NPI General Practice Physician · War, WV

NPI 1447218458 · NPPES record last updated Mar 23, 2010

Key facts

NPI
1447218458
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Physician 208D00000X
License
13158 (WV)
Practice address
11710 Main St
War, WV 24892-0250
Phone
(304) 875-2299
Fax
(304) 875-2205
NPI assigned
May 2, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
13158WVMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Visiting Caregivers LLC Past
since Jun 16, 2009
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 13158 WV Yes

Addresses

Primary practice location

11710 Main St
War, WV 24892-0250

Mailing address

PO Box 250
11710 Main St
War, WV 24892-0250
Phone (304) 875-2299

Other providers in War, WV

All providers in War, WV · General Practice Physician in West Virginia

Sources for this page

Verify at the official NPI Registry.