Provider Demographics
NPI:1730175399
Name:KAPUR, NEERAJ (MD)
Entity type:Individual
Prefix:
First Name:NEERAJ
Middle Name:
Last Name:KAPUR
Suffix:
Gender:M
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:PO BOX 660024
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75266-0024
Mailing Address - Country:US
Mailing Address - Phone:302-733-0806
Mailing Address - Fax:302-733-0854
Practice Address - Street 1:701 N. CLAYTON ST.
Practice Address - Street 2:3RD FLOOR
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-3518
Practice Address - Country:US
Practice Address - Phone:302-421-4330
Practice Address - Fax:302-421-4331
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2012-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10007252207L00000X
DEC1-0007252207LP2900X
PAMD420999207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000032852Medicaid
DEP00724831OtherRAILROAD MEDICARE PTAN
DEP00729246OtherRAILROAD MEDICARE PTAN
PA102332693Medicaid
PAP00766457OtherRAILROAD MEDICARE PTAN
PAP00766457OtherRAILROAD MEDICARE PTAN
DE1000032852Medicaid
PA193835Medicare PIN
PA102332693Medicaid
PA123328Q01Medicare PIN