Provider Demographics
NPI:1740446087
Name:KAPOOR-MOHIMEN, BONU (MD)
Entity type:Individual
Prefix:
First Name:BONU
Middle Name:
Last Name:KAPOOR-MOHIMEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:BONU
Other - Middle Name:
Other - Last Name:KAPOOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:90 LIBBEY INDUSTRIAL PKWY
Mailing Address - Street 2:
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02189-3129
Mailing Address - Country:US
Mailing Address - Phone:781-682-5900
Mailing Address - Fax:781-331-1764
Practice Address - Street 1:90 LIBBEY INDUSTRIAL PKWY
Practice Address - Street 2:
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02189-3129
Practice Address - Country:US
Practice Address - Phone:781-682-5900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-06
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA238878207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
042297845OtherMULTI-PLAN
097268OtherTUFTS HEALTH CARE
042297845OtherGREAT WEST HEALTH CARE
042297845OtherHVMA/FIRST HEALTH/COVENTRY
1740446087OtherNEIGHBORHOOD HEALTH PLAN
3293013OtherCIGNA
AA137192OtherHARVARD PILGRIM
042297845OtherTRICARE
042297845OtherGIC/UNICARE
1740446087OtherFALLON HEALTH CARE
MA2166305Medicaid
9475264OtherAETNA
MAJ44362OtherBCBSMA
097268OtherTUFTS MEDICARE PREFERRED
P00724386OtherMEDICARE RR
042297845OtherUNITED HEALTH CARE
042297845OtherGREAT WEST HEALTH CARE