Provider Demographics
NPI:1609856541
Name:RAJESH, KUMBLE R (MD)
Entity Type:Individual
Prefix:
First Name:KUMBLE
Middle Name:R
Last Name:RAJESH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:161 JACKSON ST
Mailing Address - Street 2:LOWELL COMMUNITY HEALTH CENTER
Mailing Address - City:LOWELL
Mailing Address - State:MA
Mailing Address - Zip Code:01852-2103
Mailing Address - Country:US
Mailing Address - Phone:978-937-9700
Mailing Address - Fax:978-446-9830
Practice Address - Street 1:161 JACKSON ST
Practice Address - Street 2:LOWELL COMMUNITY HEALTH CENTER
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01852-2103
Practice Address - Country:US
Practice Address - Phone:978-937-9700
Practice Address - Fax:978-446-9830
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2014-07-25
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Provider Licenses
StateLicense IDTaxonomies
MA154408208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
042881348OtherCHOICECARE
978645OtherNETWORK HEALTH
MA1305557Medicaid
204630OtherHARVARD PILGRIM HEALTH
3368449OtherAETNA
042881348OtherONE HEALTH
1290748OtherUNITED HEALTH CARE
36266OtherFALLON
0012337OtherNEIGHBORHOOD HEALTH PLAN
2070153OtherCIGNA
042881348OtherUNICARE
J18537OtherBLUE CROSS BLUE SHIELD
042881348OtherBEECH STREET
791175OtherTUFTS
3368449OtherAETNA
791175OtherTUFTS