Provider Demographics
NPI:1649261843
Name:KAPDI, CHANDRAKANT C (MD)
Entity type:Individual
Prefix:DR
First Name:CHANDRAKANT
Middle Name:C
Last Name:KAPDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1650 FORT ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:TRENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48183-2041
Mailing Address - Country:US
Mailing Address - Phone:734-675-7100
Mailing Address - Fax:734-675-7103
Practice Address - Street 1:1650 FORT ST
Practice Address - Street 2:SUITE D
Practice Address - City:TRENTON
Practice Address - State:MI
Practice Address - Zip Code:48183-2041
Practice Address - Country:US
Practice Address - Phone:734-675-7100
Practice Address - Fax:734-675-7103
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MICK0316932085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0824461Medicare ID - Type Unspecified
MIA73627Medicare UPIN