Provider Demographics
NPI:1376571513
Name:KUMAR, SHAILENDRA (MD)
Entity Type:Individual
Prefix:DR
First Name:SHAILENDRA
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 1:7500 GREENWAY CENTER DR
Mailing Address - Street 2:8TH FLOOR
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-3502
Mailing Address - Country:US
Mailing Address - Phone:301-477-2000
Mailing Address - Fax:301-474-2389
Practice Address - Street 1:7500 GREENWAY CENTER DR
Practice Address - Street 2:8TH FLOOR
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-3502
Practice Address - Country:US
Practice Address - Phone:301-477-2000
Practice Address - Fax:301-474-2389
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0018198208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD001751500Medicaid
MDM05021OtherSTATE CDS NUMBER
DCMD6694OtherLICENCE NUMBER
MD061985OtherUSMLE/ECFMG
MDD0018198OtherLICENCE NUMBER
MDD0018198OtherLICENCE NUMBER
MDM05021OtherSTATE CDS NUMBER
MD145639Medicare ID - Type Unspecified