Basic Information
| Provider Information | |||||||||
| NPI: | 1700973484 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KAPOOR | ||||||||
| FirstName: | SURRINDER | ||||||||
| MiddleName: | S | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2336 GODDARD PARKWAY | ||||||||
| Address2: | |||||||||
| City: | SALISBURY | ||||||||
| State: | MD | ||||||||
| PostalCode: | 21801 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103346961 | ||||||||
| FaxNumber: | 4103346960 | ||||||||
| Practice Location | |||||||||
| Address1: | 2336 GODDARD PARKWAY | ||||||||
| Address2: | |||||||||
| City: | SALISBURY | ||||||||
| State: | MD | ||||||||
| PostalCode: | 21801 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103346961 | ||||||||
| FaxNumber: | 4103346960 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/06/2006 | ||||||||
| LastUpdateDate: | 03/26/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | D0052766 | MD | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 100026410 | 01 | AMERICAN PSYCH SYSTEM | OTHER | 576618 | 01 | UNITED HEALTH CARE MAMSI | OTHER | 609550001 | 05 | MD | MEDICAID | 609550004 | 05 | MD | MEDICAID | LM49EA | 01 | MD | CAREFIRST BCBS GROUP | OTHER | 522156095 | 01 | MD | UNITED BEHAVIORAL HEALTH | OTHER | 733634 | 01 | NCPPO PIN | OTHER | R968 | 01 | CARE1ST FEDERAL GROUP DC | OTHER | 0002 | 01 | CAREFIRST FEDERAL PIN DC | OTHER | 252972000 | 01 | MD | MAGELLAN PIN | OTHER | 522156095 | 01 | MD | AETNA | OTHER | 85070704 | 01 | MD | CAREFIRST BCBS PIN | OTHER | 259147000 | 01 | MD | MAGELLAN GROUP | OTHER | 609550002 | 05 | MD | MEDICAID | 5221560950001 | 01 | TRICARE | OTHER | 141675 | 01 | MD | VALUE OPTIONS | OTHER | 517251 | 01 | UHC MAMSI GROUP # | OTHER |