Provider Demographics
NPI:1326001496
Name:KAPS, IGOR G (MD)
Entity Type:Individual
Prefix:
First Name:IGOR
Middle Name:G
Last Name:KAPS
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1541 GULL RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49048-1639
Mailing Address - Country:US
Mailing Address - Phone:269-381-7380
Mailing Address - Fax:269-341-4562
Practice Address - Street 1:1541 GULL RD
Practice Address - Street 2:SUITE 100
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49048-1639
Practice Address - Country:US
Practice Address - Phone:269-381-7380
Practice Address - Fax:269-341-4562
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI43010619302084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2957389Medicaid
MI4733760Medicaid
MI2957389Medicaid