Provider Demographics
NPI:1821282526
Name:SHIVKUMAR, ABHIJIT (MD)
Entity Type:Individual
Prefix:DR
First Name:ABHIJIT
Middle Name:
Last Name:SHIVKUMAR
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 1:225 E JACKSON
Mailing Address - Street 2:ST BERNARDS MEDICAL CENTER
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72401-3119
Mailing Address - Country:US
Mailing Address - Phone:501-681-4841
Mailing Address - Fax:
Practice Address - Street 1:225 E JACKSON
Practice Address - Street 2:ST BERNARDS MEDICAL CENTER
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-3119
Practice Address - Country:US
Practice Address - Phone:501-681-4841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-05
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-6549208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist