Provider Demographics
NPI:1376776534
Name:KUMAR, JITENDRA (MD)
Entity Type:Individual
Prefix:
First Name:JITENDRA
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 1:26300 VILLAGE LN
Mailing Address - Street 2:APT # P5 ATRIUM II
Mailing Address - City:BEACHWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44122-7565
Mailing Address - Country:US
Mailing Address - Phone:216-533-8712
Mailing Address - Fax:
Practice Address - Street 1:CLEVELAND CLINIC 9500 EUCLID AVE
Practice Address - Street 2:J4-133
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:216-445-6816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-03
Last Update Date:2009-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program