Provider Demographics
NPI:1376986125
Name:KUMRAL, ABIGAIL V (MD)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:V
Last Name:KUMRAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:PATRICIA
Other - Last Name:VAN WYK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 9007
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22906-9007
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2955 IVY RD STE 303
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22903-9353
Practice Address - Country:US
Practice Address - Phone:434-980-6555
Practice Address - Fax:434-243-1004
Is Sole Proprietor?:No
Enumeration Date:2013-04-11
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
VA0101259927208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1376986125Medicaid