Provider Demographics
NPI:1336192491
Name:KUMAR, SHREEJA K (MD)
Entity Type:Individual
Prefix:DR
First Name:SHREEJA
Middle Name:K
Last Name:KUMAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:635 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67203-3602
Mailing Address - Country:US
Mailing Address - Phone:316-660-7600
Mailing Address - Fax:316-383-7925
Practice Address - Street 1:1929 W 21ST ST N
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-2106
Practice Address - Country:US
Practice Address - Phone:316-660-7750
Practice Address - Fax:316-838-2115
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-283372084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS9766OtherPREFERRED HEALTH SYSTEMS
KS101155OtherBLUE CROSS BLUE SHIELD
KS2157344OtherCIGNA
KSH46872Medicare UPIN
KS9766OtherPREFERRED HEALTH SYSTEMS