Provider Demographics
NPI:1730461237
Name:KUMAR, AJAY (MD)
Entity type:Individual
Prefix:
First Name:AJAY
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 1:167 W MAIN RD STE F
Mailing Address - Street 2:
Mailing Address - City:CONNEAUT
Mailing Address - State:OH
Mailing Address - Zip Code:44030-2057
Mailing Address - Country:US
Mailing Address - Phone:440-599-7466
Mailing Address - Fax:440-593-6498
Practice Address - Street 1:167 W MAIN RD STE F
Practice Address - Street 2:
Practice Address - City:CONNEAUT
Practice Address - State:OH
Practice Address - Zip Code:44030-2057
Practice Address - Country:US
Practice Address - Phone:440-599-7466
Practice Address - Fax:440-593-6498
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-12
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.125180207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine