Provider Demographics
NPI:1295710994
Name:KUMAR, PRADEEP (MD)
Entity type:Individual
Prefix:DR
First Name:PRADEEP
Middle Name:
Last Name:KUMAR
Suffix:
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 1:2219 WOODMONT DR
Mailing Address - Street 2:
Mailing Address - City:EXPORT
Mailing Address - State:PA
Mailing Address - Zip Code:15632-8939
Mailing Address - Country:US
Mailing Address - Phone:724-837-8118
Mailing Address - Fax:
Practice Address - Street 1:527 W NEWTON ST
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-2819
Practice Address - Country:US
Practice Address - Phone:724-837-8118
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD039658L207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1127390Medicaid
PA162053OtherHIGHMARK BC BS
PA162053Medicare ID - Type UnspecifiedPROVIDER NUMBER
PA1127390Medicaid