Provider Demographics
NPI:1801939772
Name:NEUPANE, PRITAM (MBBS)
Entity type:Individual
Prefix:DR
First Name:PRITAM
Middle Name:
Last Name:NEUPANE
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 ONYX ST
Mailing Address - Street 2:
Mailing Address - City:KEMMERER
Mailing Address - State:WY
Mailing Address - Zip Code:83101-3214
Mailing Address - Country:US
Mailing Address - Phone:307-800-8708
Mailing Address - Fax:
Practice Address - Street 1:6555 COYLE AVE STE 215
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-0303
Practice Address - Country:US
Practice Address - Phone:916-536-2442
Practice Address - Fax:916-536-2598
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDP20609207R00000X
MT76276207RC0200X, 207RP1001X
CAC167782207RP1001X
WY9223A207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine