Provider Demographics
NPI:1518967439
Name:KAPUR, SUBHASH (PT)
Entity Type:Individual
Prefix:MR
First Name:SUBHASH
Middle Name:
Last Name:KAPUR
Suffix:
Gender:M
Credentials:PT
Other - Prefix:MR
Other - First Name:SUBHASH
Other - Middle Name:
Other - Last Name:KAPUR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHYSICAL THERAPIST
Mailing Address - Street 1:4676 AVONDALE TER
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48304-3600
Mailing Address - Country:US
Mailing Address - Phone:248-566-1180
Mailing Address - Fax:866-316-9232
Practice Address - Street 1:7164 N MAIN ST
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:MI
Practice Address - Zip Code:48346-1569
Practice Address - Country:US
Practice Address - Phone:248-625-6400
Practice Address - Fax:866-315-9232
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501000673225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist