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General NPI Number Information
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NPI Number | 1467600213
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Entity Type | Organization
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Legal Business Name | SHIV SUMAN KAPOOR PC
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Dates
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Enumeration Date | 09/05/2008
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Last Update Date | 09/05/2008
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Provider Practice Location Address
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Address Line | 1728 VIRGINIA AVE
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City | CONNERSVILLE
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State | IN
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Zip | 47331-2830
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Country | US
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Telephone | 765-825-4044
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Fax | 765-825-4110
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Provider Business Mailing Address
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Address Line | 1728 VIRGINIA AVE
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City | CONNERSVILLE
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State | IN
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Zip | 47331-2830
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Country | US
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Telephone | 765-825-4044
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Fax | 765-825-4110
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. SEEMA U KAPOOR
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Credential | M.D.
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Telephone | 513-234-0665
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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