Provider Demographics
NPI:1255386397
Name:KUMAR, ASHOK (MD)
Entity type:Individual
Prefix:DR
First Name:ASHOK
Middle Name:
Last Name:KUMAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:12639 OLD TESSON RD
Mailing Address - Street 2:SUITE115
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-2786
Mailing Address - Country:US
Mailing Address - Phone:314-849-0311
Mailing Address - Fax:314-849-4423
Practice Address - Street 1:12639 OLD TESSON RD
Practice Address - Street 2:SUITE115
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-2786
Practice Address - Country:US
Practice Address - Phone:314-849-0311
Practice Address - Fax:314-849-4423
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2019-07-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO105798208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO5184535OtherAETNA
MO250010379OtherRAILROAD MEDICARE
MO54543OtherGROUP HEALTH PLAN
MO2307210OtherUNITED HEALTHCARE
MO335523OtherHEALTHLINK
MO111624OtherBLUE CROSS BLUE SHIELD
MO208726513Medicaid
MO5462700002OtherCIGNA