Provider Demographics
NPI:1417996372
Name:KUMARAMANGALAM, SCARIYA M (MD)
Entity Type:Individual
Prefix:DR
First Name:SCARIYA
Middle Name:M
Last Name:KUMARAMANGALAM
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 1:219 LONGWOOD DR SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-5243
Mailing Address - Country:US
Mailing Address - Phone:256-265-6170
Mailing Address - Fax:256-265-6173
Practice Address - Street 1:219 LONGWOOD DR SW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5243
Practice Address - Country:US
Practice Address - Phone:256-265-6170
Practice Address - Fax:256-265-6173
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL000204232084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL331434464Medicaid
ALG50806Medicare UPIN
AL000051782KUMMedicare ID - Type Unspecified