Provider Demographics
NPI:1013236264
Name:KAPUR, SHWETA (MS, PT)
Entity Type:Individual
Prefix:
First Name:SHWETA
Middle Name:
Last Name:KAPUR
Suffix:
Gender:F
Credentials:MS, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1202 CATALPA DR
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-1127
Mailing Address - Country:US
Mailing Address - Phone:248-543-2070
Mailing Address - Fax:248-543-2056
Practice Address - Street 1:1202 CATALPA DR
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067-1127
Practice Address - Country:US
Practice Address - Phone:248-543-2070
Practice Address - Fax:248-543-2056
Is Sole Proprietor?:No
Enumeration Date:2010-05-27
Last Update Date:2016-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY032356225100000X
MI5501015966225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist