Provider Demographics
NPI:1245212364
Name:KAPADIA, MITESH K (MD)
Entity Type:Individual
Prefix:DR
First Name:MITESH
Middle Name:K
Last Name:KAPADIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 WASHINGTON ST
Mailing Address - Street 2:BOX 750
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02111-1526
Mailing Address - Country:US
Mailing Address - Phone:617-636-7770
Mailing Address - Fax:617-636-0759
Practice Address - Street 1:750 WASHINGTON ST
Practice Address - Street 2:BOX 750
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02111-1526
Practice Address - Country:US
Practice Address - Phone:617-636-7770
Practice Address - Fax:617-636-0759
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA223549207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAAA28838OtherHARVARD PILGRIM HEALTH CA
MA486843OtherTUFTS HEALTH PLAN
MA2099853Medicaid
MAJ28537OtherBC BS
MAA38693Medicare ID - Type Unspecified
MAI42241Medicare UPIN
MAA39210Medicare ID - Type Unspecified