Provider Demographics
NPI:1407810427
Name:KUMAR, PARMOD (MD)
Entity Type:Individual
Prefix:
First Name:PARMOD
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 1:7400 W RAWSON AVE
Mailing Address - Street 2:SUITE 115
Mailing Address - City:FRANKLIN
Mailing Address - State:WI
Mailing Address - Zip Code:53132-8278
Mailing Address - Country:US
Mailing Address - Phone:414-529-1944
Mailing Address - Fax:
Practice Address - Street 1:7400 W RAWSON AVE
Practice Address - Street 2:SUITE 115
Practice Address - City:FRANKLIN
Practice Address - State:WI
Practice Address - Zip Code:53132-8278
Practice Address - Country:US
Practice Address - Phone:414-529-1944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-14
Last Update Date:2013-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI21755208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
020028298OtherRR MEDICARE
WI30396300Medicaid
WIB54374Medicare UPIN
WI000101348Medicare PIN