Provider Demographics
NPI:1356362792
Name:KUMAR, MADHURESH (MD)
Entity type:Individual
Prefix:
First Name:MADHURESH
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 1:5709 W 131ST ST
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66209-3638
Mailing Address - Country:US
Mailing Address - Phone:772-708-4604
Mailing Address - Fax:772-404-7939
Practice Address - Street 1:130 E LOCKLING ST
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:MO
Practice Address - Zip Code:64628-2337
Practice Address - Country:US
Practice Address - Phone:660-258-2222
Practice Address - Fax:866-368-6349
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20190008703207P00000X
IN01078179A207R00000X
WI66908207R00000X
LA343364207R00000X
GA44949207R00000X
COCDR.0002580207R00000X
MN63310207R00000X
KS04-41167207R00000X
FLME74870207R00000X
MO2019008703207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL253505000Medicaid
FLG01742Medicare UPIN
FL42610Medicare PIN