Healthcare Provider Details

I. General information

NPI: 1588610034
Provider Name (Legal Business Name): RAMA KAPOOR M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RAMA AGARWAL MBBS

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 08/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 E CHESTNUT ST UNIT 310
LOUISVILLE KY
40202-5703
US

IV. Provider business mailing address

501 E BROADWAY STE. 290
LOUISVILLE KY
40202-1785
US

V. Phone/Fax

Practice location:
  • Phone: 502-584-8563
  • Fax: 502-589-5093
Mailing address:
  • Phone: 502-217-8221
  • Fax: 502-217-5056

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number41641
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: