Provider Demographics
NPI:1851533665
Name:SURRINDER KAPOOR, MD, PC
Entity Type:Organization
Organization Name:SURRINDER KAPOOR, MD, PC
Other - Org Name:SURRINDER KAPOOR, MD, PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:KAPOOR
Authorized Official - Suffix:
Authorized Official - Credentials:MHARN
Authorized Official - Phone:443-880-2734
Mailing Address - Street 1:705 CANVASBACK CT
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-8682
Mailing Address - Country:US
Mailing Address - Phone:443-880-2734
Mailing Address - Fax:410-749-3440
Practice Address - Street 1:705 CANVASBACK CT
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-8682
Practice Address - Country:US
Practice Address - Phone:443-880-2734
Practice Address - Fax:410-749-3440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-26
Last Update Date:2009-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00527662084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD5223220502OtherMAGELLAN