Individual
RAHUL KAPOOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
631 PROFESSIONAL DR STE 170, LAWRENCEVILLE, GA 30046-3392
(678) 312-2663
(770) 962-8587
Mailing address
PO BOX 370, FORTSON, GA 31808-0370
(706) 494-3008
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
8464
GA
Other
Enumeration date
08/31/2017
Last updated
09/11/2020
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