MEDICARE: KAPIL DUA P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	5501005873	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00036123	OTHER	MI	MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0E05734	OTHER	MI	BCBS NUMBER

General Provider Information

NPI Number	:	1194833269
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAPIL DUA P.T.

Provider Business Mailing Address
First Line	:	30445 NORTHWESTERN HWY
Second Line	:	STE. 280
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48334-3158
Country	:	US
Telephone Number	:	248-865-7380
Fax Number	:	248-865-7480

Provider Business Practice Location Address
First Line	:	30445 NORTHWESTERN HWY
Second Line	:	STE. 280
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48334-3158
Country	:	US
Telephone Number	:	248-865-7380
Fax Number	:	248-865-7480

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/28/2006
Last Update Date	:	07/08/2007

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Directions to “ KAPIL DUA P.T.” Practice Location

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