Provider Demographics
NPI:1538102470
Name:KAPASI, AMARISH R (MD)
Entity Type:Individual
Prefix:
First Name:AMARISH
Middle Name:R
Last Name:KAPASI
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 1:2542 TWILIGHT VW
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-7722
Mailing Address - Country:US
Mailing Address - Phone:678-344-4628
Mailing Address - Fax:
Practice Address - Street 1:2542 TWILIGHT VW
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-7722
Practice Address - Country:US
Practice Address - Phone:678-344-4628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-14
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0547592081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAH83324Medicare UPIN
GA25BBFXNMedicare PIN