Provider Demographics
NPI:1801836127
Name:KUMRA, SANJIV (MD)
Entity Type:Individual
Prefix:
First Name:SANJIV
Middle Name:
Last Name:KUMRA
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:2312 S 6TH ST
Mailing Address - Street 2:SUITE F256/2B W
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55454-1336
Mailing Address - Country:US
Mailing Address - Phone:612-273-8700
Mailing Address - Fax:612-273-9779
Practice Address - Street 1:2312 S 6TH ST
Practice Address - Street 2:SUITE F256/2B W
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454-1336
Practice Address - Country:US
Practice Address - Phone:612-273-8700
Practice Address - Fax:612-273-9779
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2012-07-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN484802084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry