Provider Demographics
NPI:1871524322
Name:KUMAR, DHRUVA (MD)
Entity type:Individual
Prefix:DR
First Name:DHRUVA
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 1:285 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:BUNN
Mailing Address - State:NC
Mailing Address - Zip Code:27508-0368
Mailing Address - Country:US
Mailing Address - Phone:919-496-6511
Mailing Address - Fax:919-496-2889
Practice Address - Street 1:285 MAIN STREET
Practice Address - Street 2:
Practice Address - City:BUNN
Practice Address - State:NC
Practice Address - Zip Code:27508-0368
Practice Address - Country:US
Practice Address - Phone:919-496-6511
Practice Address - Fax:919-496-2889
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9500122207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8950356Medicaid
NC8950356Medicaid
NC2208387Medicare ID - Type UnspecifiedFOR DHRUVA KUMAR