Provider Demographics
NPI:1073756441
Name:KUMAR, PRASHANT (MD)
Entity Type:Individual
Prefix:
First Name:PRASHANT
Middle Name:
Last Name:KUMAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:102 SHORE DRIVE
Mailing Address - Street 2:STE 502
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-3154
Mailing Address - Country:US
Mailing Address - Phone:508-425-7670
Mailing Address - Fax:508-425-7671
Practice Address - Street 1:102 SHORE DRIVE
Practice Address - Street 2:STE 502
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01605-3154
Practice Address - Country:US
Practice Address - Phone:508-425-7670
Practice Address - Fax:508-425-7671
Is Sole Proprietor?:No
Enumeration Date:2009-04-14
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036.132266207LP2900X
MA258822207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine