Healthcare Provider Details

I. General information

NPI: 1639144926
Provider Name (Legal Business Name): GAYATRI KAPUR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2006
Last Update Date: 10/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2075 GLENN MITCHELL DR STE 500
VIRGINIA BEACH VA
23456-0179
US

IV. Provider business mailing address

PO BOX 936
NORFOLK VA
23501-0936
US

V. Phone/Fax

Practice location:
  • Phone: 757-446-7900
  • Fax: 757-446-8907
Mailing address:
  • Phone: 757-446-7900
  • Fax: 757-446-8907

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number0101230621
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: