Provider Demographics
NPI:1568425692
Name:KUMBAR, CHANDRASHEKAR (MD)
Entity Type:Individual
Prefix:DR
First Name:CHANDRASHEKAR
Middle Name:
Last Name:KUMBAR
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 1:4015 GATEWAY BLVD
Mailing Address - Street 2:SUITE 2120
Mailing Address - City:NEWBURGH
Mailing Address - State:IN
Mailing Address - Zip Code:47630-9460
Mailing Address - Country:US
Mailing Address - Phone:812-842-0907
Mailing Address - Fax:812-464-4485
Practice Address - Street 1:4015 GATEWAY BLVD
Practice Address - Street 2:SUITE 2120
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-9460
Practice Address - Country:US
Practice Address - Phone:812-842-0907
Practice Address - Fax:812-464-0555
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01058079A207RC0000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000297981OtherANTHEM
IN200482160AMedicaid
KY64087463Medicaid
KY64087463Medicaid
IN532500YYMedicare PIN
IN330005278Medicare PIN
ILK02634Medicare PIN
IN200482160AMedicaid
IN200482160AMedicaid