Provider Demographics
NPI:1881001444
Name:KABIR, SUMONA (DO)
Entity Type:Individual
Prefix:
First Name:SUMONA
Middle Name:
Last Name:KABIR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7222 ENGLE RD.
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46804-2222
Mailing Address - Country:US
Mailing Address - Phone:260-432-5005
Mailing Address - Fax:260-432-6003
Practice Address - Street 1:7222 ENGLE RD.
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46804-2222
Practice Address - Country:US
Practice Address - Phone:260-432-5005
Practice Address - Fax:260-432-6003
Is Sole Proprietor?:No
Enumeration Date:2014-07-16
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI71419-21207K00000X
IN02086824A207K00000X, 207R00000X
FLOS14773207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology