Provider Demographics
NPI:1568639466
Name:VASANTHA KUMAR, SANTHOSH KUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:SANTHOSH KUMAR
Middle Name:
Last Name:VASANTHA KUMAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:SANTHOSH KUMAR
Other - Middle Name:
Other - Last Name:BANGALORE VASANTHA KUMAR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 91734
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23291-1734
Mailing Address - Country:US
Mailing Address - Phone:804-358-6100
Mailing Address - Fax:804-342-7619
Practice Address - Street 1:1000 E BROAD ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23219-1930
Practice Address - Country:US
Practice Address - Phone:804-628-7337
Practice Address - Fax:804-628-0267
Is Sole Proprietor?:No
Enumeration Date:2008-05-11
Last Update Date:2020-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
VA01012476882080P0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology
No174400000XOther Service ProvidersSpecialist