Provider Demographics
NPI:1780644013
Name:DASMAHAPATRA, KUMAR S (MD)
Entity Type:Individual
Prefix:
First Name:KUMAR
Middle Name:S
Last Name:DASMAHAPATRA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:225 MAY ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837-3266
Mailing Address - Country:US
Mailing Address - Phone:732-346-5400
Mailing Address - Fax:732-346-5404
Practice Address - Street 1:225 MAY ST
Practice Address - Street 2:SUITE A
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-3266
Practice Address - Country:US
Practice Address - Phone:732-346-5400
Practice Address - Fax:732-346-5404
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2014-04-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJNJMA40626208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJC62903Medicare UPIN