Provider Demographics
NPI:1619986940
Name:KAPADIA, ATUL P (MD)
Entity Type:Individual
Prefix:
First Name:ATUL
Middle Name:P
Last Name:KAPADIA
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 1:4900 N CENTAURS CT
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-4203
Mailing Address - Country:US
Mailing Address - Phone:703-897-8389
Mailing Address - Fax:703-897-5669
Practice Address - Street 1:1966 OPITZ BLVD
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-3304
Practice Address - Country:US
Practice Address - Phone:703-897-8389
Practice Address - Fax:571-398-6358
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2017-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101057778207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5282681OtherAETNA
VA5873177Medicaid
020603979OtherTAX ID
2165485OtherUNITED HEALTHCARE
VA385618OtherANTHEM, BCBS
VA5282681OtherAETNA
G80749Medicare UPIN
DC00B233C14Medicare ID - Type UnspecifiedMEDICARE, DC
2165485OtherUNITED HEALTHCARE