Provider Demographics
NPI:1003974452
Name:KUMAR, SURESH (MD)
Entity Type:Individual
Prefix:
First Name:SURESH
Middle Name:
Last Name:KUMAR
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 1:17225 EMERALD CHASE DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-2784
Mailing Address - Country:US
Mailing Address - Phone:813-968-7637
Mailing Address - Fax:914-419-2851
Practice Address - Street 1:13000 BRUCE B. DOWNS BLVD
Practice Address - Street 2:JAMES A HALEY VETERANS' HOSPITAL
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33612-4745
Practice Address - Country:US
Practice Address - Phone:813-972-6209
Practice Address - Fax:914-419-2851
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY213873207R00000X
FLME 103572207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine