Provider Demographics
NPI:1548751225
Name:KAUR, KOMAL PREET (MBBS)
Entity type:Individual
Prefix:DR
First Name:KOMAL
Middle Name:PREET
Last Name:KAUR
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 EXECUTIVE PARK DR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-2206
Mailing Address - Country:US
Mailing Address - Phone:404-727-5658
Mailing Address - Fax:
Practice Address - Street 1:3125 CHAD DR
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97408-7440
Practice Address - Country:US
Practice Address - Phone:541-687-1712
Practice Address - Fax:541-687-7943
Is Sole Proprietor?:No
Enumeration Date:2018-05-29
Last Update Date:2025-07-25
Deactivation Date:2019-01-22
Deactivation Code:
Reactivation Date:2020-08-14
Provider Licenses
StateLicense IDTaxonomies
GA010533390200000X
390200000X
ORMD224658207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program