Provider Demographics
NPI:1790830636
Name:KUMAR, JAI R (MD)
Entity Type:Individual
Prefix:
First Name:JAI
Middle Name:R
Last Name:KUMAR
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Gender:M
Credentials:MD
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Mailing Address - Street 1:186 MEDICAL PARK LOOP
Mailing Address - Street 2:STE 501
Mailing Address - City:SYLVA
Mailing Address - State:NC
Mailing Address - Zip Code:28779-5222
Mailing Address - Country:US
Mailing Address - Phone:828-586-5594
Mailing Address - Fax:828-586-3040
Practice Address - Street 1:154 MEDICAL PARK LOOP STE A
Practice Address - Street 2:
Practice Address - City:SYLVA
Practice Address - State:NC
Practice Address - Zip Code:28779-5271
Practice Address - Country:US
Practice Address - Phone:828-307-0900
Practice Address - Fax:866-340-6013
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2024-02-12
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Provider Licenses
StateLicense IDTaxonomies
NC9901562208000000X, 2080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891242NMedicaid
NC891242NMedicaid
NC3837597Medicare ID - Type Unspecified