MEDICARE: SANJEEV KAPURIA MD

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	207L00000X	Anesthesiology Physician	057090	GA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P00320036	OTHER	GA	RRMEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	339463	OTHER	GA	WELLCARE CMO
2	198493	OTHER	GA	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	550789920	OTHER	GA	TRICARE

General Provider Information

NPI Number	:	1912088337
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANJEEV KAPURIA MD

Provider Business Mailing Address
First Line	:	455 PHILIP BLVD STE 140
Second Line	:
City	:	LAWRENCEVILLE
State	:	GA
Zip	:	30046-8768
Country	:	US
Telephone Number	:	770-962-3642
Fax Number	:	770-962-3643

Provider Business Practice Location Address
First Line	:	526 BANKHEAD HWY STE 101
Second Line	:
City	:	CARROLLTON
State	:	GA
Zip	:	30117-2463
Country	:	US
Telephone Number	:	770-962-3642
Fax Number	:	770-962-3643

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

Provider Enumeration Date	:	10/19/2006
Last Update Date	:	01/16/2026

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Directions to “ SANJEEV KAPURIA MD” Practice Location

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