Provider Demographics
NPI:1811978661
Name:KUMAR, SHEKAR P (MD)
Entity type:Individual
Prefix:
First Name:SHEKAR
Middle Name:P
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 1:421 EPTING AVE
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29646-4041
Mailing Address - Country:US
Mailing Address - Phone:864-227-6818
Mailing Address - Fax:864-227-1037
Practice Address - Street 1:421 EPTING AVE
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29646-4041
Practice Address - Country:US
Practice Address - Phone:864-227-6818
Practice Address - Fax:864-227-1037
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC30252207RC0000X, 207RC0000X
VA0101233702207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC302522Medicaid
SC302522Medicaid
SC30252OtherLICENSE NUMBER