Provider Demographics
NPI:1376806497
Name:KUMAR, NAVANEETH CHANDRU (MBBS)
Entity Type:Individual
Prefix:
First Name:NAVANEETH
Middle Name:CHANDRU
Last Name:KUMAR
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:
Other - First Name:FNU
Other - Middle Name:
Other - Last Name:NAVANEETH CHANDRU KUM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2400 S AVENUE A
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85364-7127
Mailing Address - Country:US
Mailing Address - Phone:928-336-1290
Mailing Address - Fax:520-626-2247
Practice Address - Street 1:2400 S AVENUE A
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-7127
Practice Address - Country:US
Practice Address - Phone:928-336-1290
Practice Address - Fax:520-626-2247
Is Sole Proprietor?:No
Enumeration Date:2012-06-22
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR73432207Q00000X
AZ52305208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine