Provider Demographics
NPI:1013174036
Name:KUMAR, RISHI (DO)
Entity Type:Individual
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First Name:RISHI
Middle Name:
Last Name:KUMAR
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Gender:M
Credentials:DO
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Mailing Address - Street 1:5000 CEDAR PLAZA PARKWAY
Mailing Address - Street 2:SUITE 350
Mailing Address - City:ST LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128
Mailing Address - Country:US
Mailing Address - Phone:314-843-4333
Mailing Address - Fax:314-843-4856
Practice Address - Street 1:4905 MEXICO ROAD
Practice Address - Street 2:SUITE 300
Practice Address - City:ST PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376
Practice Address - Country:US
Practice Address - Phone:636-928-5109
Practice Address - Fax:636-441-1081
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2012-09-28
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Provider Licenses
StateLicense IDTaxonomies
MO20120174482084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO133500021Medicare PIN