Provider Demographics
NPI:1013470533
Name:KUMAR, JAGDESH II (MD)
Entity Type:Individual
Prefix:
First Name:JAGDESH
Middle Name:
Last Name:KUMAR
Suffix:II
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:UNIVERSITY OF MARYLAND PRINCE GEORGE'S HOSPITAL
Mailing Address - Street 2:3001 HOSPITAL DRIVE 5TH FLOOR
Mailing Address - City:CHEVERLY
Mailing Address - State:MD
Mailing Address - Zip Code:20785
Mailing Address - Country:US
Mailing Address - Phone:301-618-2272
Mailing Address - Fax:301-618-2986
Practice Address - Street 1:UNIVERSITY OF MARYLAND PRINCE GEORGE'S HOSPITAL CENTER
Practice Address - Street 2:3001 HOSPITAL DRIVE 5TH FLOOR
Practice Address - City:CHEVERLY
Practice Address - State:MD
Practice Address - Zip Code:20785
Practice Address - Country:US
Practice Address - Phone:301-618-2273
Practice Address - Fax:301-429-1949
Is Sole Proprietor?:No
Enumeration Date:2019-04-11
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD390200000XMedicaid