Individual
GURBACHAN S KAPOOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4755 AMERITECH DR, SOUTH BEND, IN 46628-9120
(574) 271-2558
(574) 273-1137
Mailing address
600 GRANT ST, GARY, IN 46402-6001
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
01026462A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000251277
ANTHEM
IN
01
—
P00051342
RAIL ROAD MEDICARE
IN
Enumeration date
08/25/2005
Last updated
12/28/2007
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