Provider Demographics
NPI:1801852215
Name:KAPOOR, SUNIL AMRIT (MD)
Entity Type:Individual
Prefix:DR
First Name:SUNIL
Middle Name:AMRIT
Last Name:KAPOOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2730 B PROSPERITY AVENUE
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-2238
Mailing Address - Country:US
Mailing Address - Phone:703-289-1400
Mailing Address - Fax:703-289-1414
Practice Address - Street 1:2730 A PROSPERITY AVENUE
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-2238
Practice Address - Country:US
Practice Address - Phone:703-289-1410
Practice Address - Fax:703-289-1420
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA01012310322080P0214X
DCMD219822080P0214X
MDD00608702080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA6716288Medicaid
VA6728094Medicaid
VA6716237Medicaid
VA6706703Medicaid