Provider Demographics
NPI:1326371717
Name:NAGPAL, KAMAL (MD)
Entity Type:Individual
Prefix:DR
First Name:KAMAL
Middle Name:
Last Name:NAGPAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 E THOMAS RD STE 230
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-3100
Mailing Address - Country:US
Mailing Address - Phone:602-557-0007
Mailing Address - Fax:602-557-0001
Practice Address - Street 1:6320 W UNION HILLS DR STE 2600B
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-1379
Practice Address - Country:US
Practice Address - Phone:602-942-5600
Practice Address - Fax:623-825-6386
Is Sole Proprietor?:No
Enumeration Date:2009-09-16
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
AZ52270208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ144366Medicaid
AZ144366Medicaid