Provider Demographics
NPI:1487615514
Name:KAPRALY, PAMELA ELIZABETH (MD)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:ELIZABETH
Last Name:KAPRALY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 W OTTAWA ST
Mailing Address - Street 2:
Mailing Address - City:RICHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:43344-1138
Mailing Address - Country:US
Mailing Address - Phone:740-943-2354
Mailing Address - Fax:740-943-5068
Practice Address - Street 1:19 W OTTAWA ST
Practice Address - Street 2:
Practice Address - City:RICHWOOD
Practice Address - State:OH
Practice Address - Zip Code:43344-1138
Practice Address - Country:US
Practice Address - Phone:740-943-2354
Practice Address - Fax:740-943-5068
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-06-0618207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0875978Medicaid
E76507Medicare UPIN
OH0875978Medicaid