Provider Demographics
NPI:1114953478
Name:KUMAR, GEETIKA (MD)
Entity Type:Individual
Prefix:DR
First Name:GEETIKA
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 1:4100 W 3RD ST
Mailing Address - Street 2:DAYTON VAMC (111W)
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45428-6064
Mailing Address - Country:US
Mailing Address - Phone:937-267-3972
Mailing Address - Fax:937-267-5310
Practice Address - Street 1:4100 W 3RD ST
Practice Address - Street 2:DAYTON VAMC (111W)
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45428-6064
Practice Address - Country:US
Practice Address - Phone:937-267-3972
Practice Address - Fax:937-267-5310
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-25
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01045466A174400000X
OH35. 088803207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHI73174Medicare UPIN