Provider Demographics
NPI:1083755789
Name:CAPELLI-SCHEIDT, REGINA A (MD)
Entity type:Individual
Prefix:
First Name:REGINA
Middle Name:A
Last Name:CAPELLI-SCHEIDT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7325 FOLEY RD
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53402-9761
Mailing Address - Country:US
Mailing Address - Phone:262-818-4684
Mailing Address - Fax:
Practice Address - Street 1:7325 FOLEY RD
Practice Address - Street 2:
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53402-9761
Practice Address - Country:US
Practice Address - Phone:262-818-4684
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI31285-0202083P0901X, 208D00000X, 207LA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LA0401XAllopathic & Osteopathic PhysiciansAnesthesiologyAddiction Medicine
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI31959700Medicaid
WI32425Medicare PIN
WI31959700Medicaid