Provider Demographics
NPI:1346346020
Name:KUMAR, MAYA CHANDRAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MAYA
Middle Name:CHANDRAN
Last Name:KUMAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MAYA
Other - Middle Name:
Other - Last Name:CHANDRAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:28600 11TH AVE S
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-3139
Mailing Address - Country:US
Mailing Address - Phone:253-815-8206
Mailing Address - Fax:253-589-4167
Practice Address - Street 1:900 VETERANS DR
Practice Address - Street 2:AMERICAN LAKE VAMC - PSHCS
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98493-0001
Practice Address - Country:US
Practice Address - Phone:253-582-8440
Practice Address - Fax:253-589-4167
Is Sole Proprietor?:No
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000420512084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry