Provider Demographics
NPI:1710949466
Name:KUMAR, SHASHI (MD)
Entity Type:Individual
Prefix:
First Name:SHASHI
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 1:1907 LEBANON CHURCH RD STE 200
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15122-2452
Mailing Address - Country:US
Mailing Address - Phone:412-653-8548
Mailing Address - Fax:
Practice Address - Street 1:1907 LEBANON CHURCH RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15122-2432
Practice Address - Country:US
Practice Address - Phone:412-653-8548
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD37794E207RG0100X
PAMD037794E174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011234440003Medicaid
PA0011234440003Medicaid
PAE18253Medicare UPIN