Provider Demographics
NPI:1114970415
Name:KUMAR, RISHI VERMA (MD)
Entity Type:Individual
Prefix:DR
First Name:RISHI
Middle Name:VERMA
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 1:4940 HAZELWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40214-1270
Mailing Address - Country:US
Mailing Address - Phone:502-368-3937
Mailing Address - Fax:
Practice Address - Street 1:4940 HAZELWOOD AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40214-1270
Practice Address - Country:US
Practice Address - Phone:502-368-3937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01056703A207W00000X
KY40981207W00000X
UT61780601205207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1035505Medicare PIN