Provider Demographics
NPI:1326076555
Name:KUMAR, SHIV (MD)
Entity Type:Individual
Prefix:DR
First Name:SHIV
Middle Name:
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 1:875 GREENLAND ROAD
Mailing Address - Street 2:BUILDING C-UNIT 10
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-4174
Mailing Address - Country:US
Mailing Address - Phone:603-422-6719
Mailing Address - Fax:603-373-6833
Practice Address - Street 1:875 GREENLAND RD
Practice Address - Street 2:BUILDING C-UNIT 10
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-4164
Practice Address - Country:US
Practice Address - Phone:603-422-6719
Practice Address - Fax:603-373-6833
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2012-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH14351207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01955742Medicaid
NY01955742Medicaid
NYBB5538Medicare ID - Type Unspecified