Healthcare Provider Details

I. General information

NPI: 1871711309
Provider Name (Legal Business Name): VIKAS KAPOOR M.D,
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2007
Last Update Date: 07/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10110 MOLECULAR DR SUITE 206
ROCKVILLE MD
20850-7539
US

IV. Provider business mailing address

10110 MOLECULAR DR SUITE 206
ROCKVILLE MD
20850-7539
US

V. Phone/Fax

Practice location:
  • Phone: 301-279-2779
  • Fax: 301-279-2767
Mailing address:
  • Phone: 301-279-2779
  • Fax: 301-279-2767

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number25MA08281600
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License NumberD0072932
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: