Provider Demographics
NPI:1609104140
Name:LINGAM V KUMAR MD SC
Entity Type:Organization
Organization Name:LINGAM V KUMAR MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LINGAM
Authorized Official - Middle Name:V
Authorized Official - Last Name:KUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-643-8500
Mailing Address - Street 1:3267 S 16TH ST
Mailing Address - Street 2:SUITE #104
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53215-4500
Mailing Address - Country:US
Mailing Address - Phone:414-643-8500
Mailing Address - Fax:414-647-5869
Practice Address - Street 1:3267 S 16TH ST
Practice Address - Street 2:SUITE #104
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53215-4500
Practice Address - Country:US
Practice Address - Phone:414-643-8500
Practice Address - Fax:414-647-5869
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-20
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WIB54373Medicare UPIN