Provider Demographics
NPI:1609902469
Name:NARINDER KUMAR DBA BETTENDORF PEDIATRIC & FAMILY PRACTICE ASSOC.
Entity Type:Organization
Organization Name:NARINDER KUMAR DBA BETTENDORF PEDIATRIC & FAMILY PRACTICE ASSOC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:NARINDER
Authorized Official - Middle Name:
Authorized Official - Last Name:KUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:563-332-3400
Mailing Address - Street 1:4017 DEVILS GLEN RD STE 200
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-7221
Mailing Address - Country:US
Mailing Address - Phone:563-332-3400
Mailing Address - Fax:563-332-4784
Practice Address - Street 1:4017 DEVILS GLEN RD STE 200
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-7221
Practice Address - Country:US
Practice Address - Phone:563-332-3400
Practice Address - Fax:563-332-4784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA30076207Q00000X
IA29998208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA4109934Medicaid