Provider Demographics
NPI:1568803575
Name:SAMPATHKUMAR, HARESH (MD)
Entity Type:Individual
Prefix:
First Name:HARESH
Middle Name:
Last Name:SAMPATHKUMAR
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 1:24 HICKORY LN
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-6020
Mailing Address - Country:US
Mailing Address - Phone:302-387-1407
Mailing Address - Fax:302-535-8551
Practice Address - Street 1:1240 MCKEE RD
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-1381
Practice Address - Country:US
Practice Address - Phone:302-387-1407
Practice Address - Fax:302-535-8551
Is Sole Proprietor?:No
Enumeration Date:2013-07-08
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC1-0013194208100000X, 2081P0301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P0301XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationBrain Injury Medicine