Provider Demographics
NPI:1649434283
Name:KAUTA, SHILPA RAJENDRA (MD)
Entity type:Individual
Prefix:
First Name:SHILPA
Middle Name:RAJENDRA
Last Name:KAUTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SHILPA
Other - Middle Name:
Other - Last Name:RAJENDRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:774 CHRISTIANA RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-4236
Mailing Address - Country:US
Mailing Address - Phone:302-623-3017
Mailing Address - Fax:
Practice Address - Street 1:774 CHRISTIANA RD
Practice Address - Street 2:SUITE 201
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-4236
Practice Address - Country:US
Practice Address - Phone:302-623-3017
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-14
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1 00103612084N0400X
PAMD4424222084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology