Provider Demographics
NPI:1669461075
Name:KUMAR, DHANANJAY (MD)
Entity Type:Individual
Prefix:DR
First Name:DHANANJAY
Middle Name:
Last Name:KUMAR
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 1:26850 PROVIDENCE PKWY
Mailing Address - Street 2:STE 370
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48374-1262
Mailing Address - Country:US
Mailing Address - Phone:248-465-4160
Mailing Address - Fax:248-465-5425
Practice Address - Street 1:37595 7 MILE RD
Practice Address - Street 2:SUITE 240
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-1003
Practice Address - Country:US
Practice Address - Phone:734-432-7713
Practice Address - Fax:734-432-7774
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-18
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5315016412207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI452075110Medicaid
MI0M96610005Medicare ID - Type Unspecified
MI452075110Medicaid