Basic Information
Provider Information
NPI: 1831452887
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KUMAR
FirstName: SHASHI
MiddleName: YELLAPPA
NamePrefix:  
NameSuffix:  
Credential: M.D.,
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3555 OLENTANGY RIVER RD STE 1080
Address2:  
City: COLUMBUS
State: OH
PostalCode: 432143984
CountryCode: US
TelephoneNumber: 6142688164
FaxNumber: 6142688406
Practice Location
Address1: 3555 OLENTANGY RIVER RD STE 1080
Address2:  
City: COLUMBUS
State: OH
PostalCode: 432143984
CountryCode: US
TelephoneNumber: 6142688164
FaxNumber: 6142688406
Other Information
ProviderEnumerationDate: 06/22/2012
LastUpdateDate: 05/01/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X35.126432OHN Allopathic & Osteopathic PhysiciansInternal Medicine 
208M00000X35.126432OHY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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