Provider Demographics
NPI:1821087578
Name:KUMAR, SHASHI L (MD)
Entity Type:Individual
Prefix:DR
First Name:SHASHI
Middle Name:L
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 1:727 WELSH RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-6357
Mailing Address - Country:US
Mailing Address - Phone:215-938-8838
Mailing Address - Fax:215-938-1751
Practice Address - Street 1:727 WELSH RD
Practice Address - Street 2:SUITE 101
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-6357
Practice Address - Country:US
Practice Address - Phone:215-938-8838
Practice Address - Fax:215-938-1751
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-17
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD034366Y208600000X, 2086S0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
B37510Medicare UPIN
128679Medicare ID - Type Unspecified