Provider Demographics
NPI:1174529481
Name:KAPOOR, INDERJIT K (MD)
Entity type:Individual
Prefix:DR
First Name:INDERJIT
Middle Name:K
Last Name:KAPOOR
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:6375 US HIGHWAY 6
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:IN
Mailing Address - Zip Code:46368-5111
Mailing Address - Country:US
Mailing Address - Phone:219-762-3196
Mailing Address - Fax:219-763-6438
Practice Address - Street 1:6375 US HIGHWAY 6
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:IN
Practice Address - Zip Code:46368-5111
Practice Address - Country:US
Practice Address - Phone:219-762-3196
Practice Address - Fax:219-763-6438
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2013-11-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01035765A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN194670EMedicare ID - Type Unspecified
INF73461Medicare UPIN