Provider Demographics
NPI:1457665671
Name:KUMAR, SANJAY (MD)
Entity Type:Individual
Prefix:DR
First Name:SANJAY
Middle Name:
Last Name:KUMAR
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Gender:M
Credentials:MD
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Mailing Address - Street 1:22201 MOROSS ROAD
Mailing Address - Street 2:SUITE 270, PBII
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48236
Mailing Address - Country:US
Mailing Address - Phone:313-343-3481
Mailing Address - Fax:313-343-7937
Practice Address - Street 1:22201 MOROSS ROAD
Practice Address - Street 2:SUITE 270, PBII
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48236
Practice Address - Country:US
Practice Address - Phone:313-343-3481
Practice Address - Fax:313-343-7937
Is Sole Proprietor?:No
Enumeration Date:2010-07-29
Last Update Date:2016-11-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI43010965462080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology