Provider Demographics
NPI:1093135113
Name:KUMAR, NITASHA (MD)
Entity Type:Individual
Prefix:
First Name:NITASHA
Middle Name:
Last Name:KUMAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2730 UNIVERSITY BLVD W STE 310
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:MD
Mailing Address - Zip Code:20902-1990
Mailing Address - Country:US
Mailing Address - Phone:301-942-7600
Mailing Address - Fax:301-942-3521
Practice Address - Street 1:2730 UNIVERSITY BLVD W STE 310
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:MD
Practice Address - Zip Code:20902-1990
Practice Address - Country:US
Practice Address - Phone:301-942-7600
Practice Address - Fax:301-942-3132
Is Sole Proprietor?:No
Enumeration Date:2014-04-16
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ390200000X
MDD0088199207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program