1033224985 NPI number — RAMAN KAPUR MD

Table of content: RAMAN KAPUR MD (NPI 1033224985)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033224985 NPI number — RAMAN KAPUR MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KAPUR
Provider First Name:
RAMAN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1033224985
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/27/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2084
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MERRIFIELD
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22116
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-899-4785
Provider Business Mailing Address Fax Number:
703-242-7848

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10810 DARNSTOWN RD
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
GAITHERSBURG
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20878
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-899-4785
Provider Business Practice Location Address Fax Number:
703-242-7848
Provider Enumeration Date:
08/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208100000X , with the licence number:  0101052229 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208100000X , with the licence number: D0036800 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 208100000X , with the licence number: MD17306 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 006803253 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 204241003 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".




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