Basic Information
| Provider Information | |||||||||
| NPI: | 1750547493 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KUMAR | ||||||||
| FirstName: | RAJIV | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 2001 | ||||||||
| Address2: | |||||||||
| City: | VALPARAISO | ||||||||
| State: | IN | ||||||||
| PostalCode: | 463842001 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 8701 BROADWAY | ||||||||
| Address2: | |||||||||
| City: | MERRILLVILLE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 464107035 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2197385565 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/01/2008 | ||||||||
| LastUpdateDate: | 08/11/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208D00000X | 01067188A | IN | N | Allopathic & Osteopathic Physicians | General Practice | 2085R0202X | 11014759A | IN | N | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | 2085R0204X | 01067188A | IN | Y | Allopathic & Osteopathic Physicians | Radiology | Vascular & Interventional Radiology | 2085N0904X | 01067188A | IN | N | Allopathic & Osteopathic Physicians | Radiology | Nuclear Radiology | 2085R0203X | 01067188A | IN | N | Allopathic & Osteopathic Physicians | Radiology | Therapeutic Radiology |
No ID Information.