Provider Demographics
NPI:1477747145
Name:KUMAR, VIJAY N (MD,)
Entity Type:Individual
Prefix:
First Name:VIJAY
Middle Name:N
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 1:610 PARK AVENUE NW
Mailing Address - Street 2:
Mailing Address - City:NORTON
Mailing Address - State:VA
Mailing Address - Zip Code:24273-1618
Mailing Address - Country:US
Mailing Address - Phone:276-325-0121
Mailing Address - Fax:276-325-0172
Practice Address - Street 1:610 PARK AVE NW
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:VA
Practice Address - Zip Code:24273-2427
Practice Address - Country:US
Practice Address - Phone:276-325-0121
Practice Address - Fax:276-325-0172
Is Sole Proprietor?:No
Enumeration Date:2007-09-05
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101243187207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0101243187OtherMEDICAL LICENSE