Provider Demographics
NPI:1801052691
Name:KAPELLA, BRYAN K (MD, MS)
Entity type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:K
Last Name:KAPELLA
Suffix:
Gender:M
Credentials:MD, MS
Other - Prefix:DR
Other - First Name:BK
Other - Middle Name:
Other - Last Name:KAPELLA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, MS
Mailing Address - Street 1:1600 CLIFTON RD NE
Mailing Address - Street 2:MS E-03
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-4018
Mailing Address - Country:US
Mailing Address - Phone:404-639-3448
Mailing Address - Fax:404-639-4441
Practice Address - Street 1:550 PEACHTREE ST NE
Practice Address - Street 2:SUITE # 7000
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2247
Practice Address - Country:US
Practice Address - Phone:404-686-5885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-01
Last Update Date:2008-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA059438207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAI28147Medicare UPIN