Basic Information
Provider Information
NPI: 1528290772
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KUMAR
FirstName: PARDEEP
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 88
Address2: 5 E ALVON ROAD SUITE 7
City: WHITE SULPHUR SPRINGS
State: WV
PostalCode: 249862373
CountryCode: US
TelephoneNumber: 3045365030
FaxNumber: 3045365051
Practice Location
Address1: 2900 1ST AVE
Address2: ROOM 1025
City: HUNTINGTON
State: WV
PostalCode: 257021241
CountryCode: US
TelephoneNumber: 3043997484
FaxNumber: 3043997579
Other Information
ProviderEnumerationDate: 08/20/2009
LastUpdateDate: 07/10/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X24972WVY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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