Healthcare Provider Details

I. General information

NPI: 1144327693
Provider Name (Legal Business Name): KAPIL RAWAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4201 LAKE BOONE TRL SUITE 1
RALEIGH NC
27607-7512
US

IV. Provider business mailing address

4201 LAKE BOONE TRL SUITE 1
RALEIGH NC
27607-7512
US

V. Phone/Fax

Practice location:
  • Phone: 919-789-8020
  • Fax: 919-789-8022
Mailing address:
  • Phone: 919-789-8020
  • Fax: 919-789-8022

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: