Provider Demographics
NPI:1124221940
Name:KUMAR, K KRISHNA (MD)
Entity Type:Individual
Prefix:DR
First Name:K
Middle Name:KRISHNA
Last Name:KUMAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:K
Other - Middle Name:KRISHNA
Other - Last Name:KUMAR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3035 EXMOOR RD
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-4131
Mailing Address - Country:US
Mailing Address - Phone:734-945-0292
Mailing Address - Fax:734-973-7028
Practice Address - Street 1:2100 PEABODY RD
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687
Practice Address - Country:US
Practice Address - Phone:707-454-3499
Practice Address - Fax:707-454-3462
Is Sole Proprietor?:No
Enumeration Date:2007-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA318012084F0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic Psychiatry