Provider Demographics
NPI:1538184338
Name:KUMAR, TUMKUR BN (MD)
Entity type:Individual
Prefix:
First Name:TUMKUR
Middle Name:BN
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 1:333 SCHOOL ST
Mailing Address - Street 2:204
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-5334
Mailing Address - Country:US
Mailing Address - Phone:401-728-0630
Mailing Address - Fax:401-728-1288
Practice Address - Street 1:333 SCHOOL ST
Practice Address - Street 2:204
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-5334
Practice Address - Country:US
Practice Address - Phone:401-728-0630
Practice Address - Fax:401-728-1288
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2011-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI5157207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI0070004131OtherMEDICARE PTAN
RITK00577Medicaid
2500130Medicare UPIN