Provider Demographics
NPI:1205896768
Name:KUMAR INTERNAL MEDICINE ASSOC. P.A.
Entity type:Organization
Organization Name:KUMAR INTERNAL MEDICINE ASSOC. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAMLESH
Authorized Official - Middle Name:K
Authorized Official - Last Name:KUMAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:252-443-1126
Mailing Address - Street 1:108 N ENGLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-2416
Mailing Address - Country:US
Mailing Address - Phone:252-443-1126
Mailing Address - Fax:252-443-1126
Practice Address - Street 1:108 N ENGLEWOOD DR
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-2416
Practice Address - Country:US
Practice Address - Phone:252-443-1126
Practice Address - Fax:252-443-1126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC01991OtherBC/BLUESHIELD GROUP NUMBE
NC8901991Medicaid
NC8901991Medicaid