Provider Demographics
NPI:1316109218
Name:CAPERTON, CHASITY C (MD)
Entity type:Individual
Prefix:
First Name:CHASITY
Middle Name:C
Last Name:CAPERTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHASITY
Other - Middle Name:S
Other - Last Name:CARPENTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1414 W FAIR AVE STE 226
Mailing Address - Street 2:
Mailing Address - City:MARQUETTE
Mailing Address - State:MI
Mailing Address - Zip Code:49855-5409
Mailing Address - Country:US
Mailing Address - Phone:906-449-1240
Mailing Address - Fax:
Practice Address - Street 1:1414 W FAIR AVE STE 226
Practice Address - Street 2:
Practice Address - City:MARQUETTE
Practice Address - State:MI
Practice Address - Zip Code:49855
Practice Address - Country:US
Practice Address - Phone:906-449-1240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-01
Last Update Date:2019-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301500189208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty