Provider Demographics
NPI:1245399757
Name:KUMAR SURGICAL CENTER LLC
Entity Type:Organization
Organization Name:KUMAR SURGICAL CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANIL
Authorized Official - Middle Name:B
Authorized Official - Last Name:KUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:248-453-0040
Mailing Address - Street 1:2450 WALTON BLVD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309-1481
Mailing Address - Country:US
Mailing Address - Phone:248-453-0040
Mailing Address - Fax:248-453-0070
Practice Address - Street 1:2450 WALTON BLVD
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48309-1481
Practice Address - Country:US
Practice Address - Phone:248-453-0040
Practice Address - Fax:248-453-0070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-08
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI636906261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1245399757OtherUNITED HEALTH CARE
MI1245399757OtherCOFINITY,PPOM
MI40024OtherBCBSM
MI1245399757OtherHEALTH PLUUS
MI0P27430Medicare ID - Type Unspecified