Provider Demographics
NPI:1134151905
Name:KAPADIA, PANNA (MD)
Entity type:Individual
Prefix:
First Name:PANNA
Middle Name:
Last Name:KAPADIA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:817 MERRIMACK ST STE 11
Mailing Address - Street 2:
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01854-3548
Mailing Address - Country:US
Mailing Address - Phone:978-454-5150
Mailing Address - Fax:978-452-7577
Practice Address - Street 1:817 MERRIMACK ST STE 11
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01854-3548
Practice Address - Country:US
Practice Address - Phone:978-454-5150
Practice Address - Fax:978-452-7577
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA047410207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA9751564Medicaid
MA9751564Medicaid
MAA63461Medicare UPIN