Provider Demographics
NPI:1184115222
Name:KUMAR, SAI R (PHD)
Entity type:Individual
Prefix:DR
First Name:SAI
Middle Name:R
Last Name:KUMAR
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10955 GLENBARR DR
Mailing Address - Street 2:
Mailing Address - City:JOHNS CREEK
Mailing Address - State:GA
Mailing Address - Zip Code:30097-7877
Mailing Address - Country:US
Mailing Address - Phone:770-881-8026
Mailing Address - Fax:
Practice Address - Street 1:22 TECHNOLOGY PKWY S
Practice Address - Street 2:
Practice Address - City:PEACHTREE CORNERS
Practice Address - State:GA
Practice Address - Zip Code:30092-9807
Practice Address - Country:US
Practice Address - Phone:470-294-2457
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-24
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA060-R-1742251E00000X, 343900000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)