Provider Demographics
NPI:1063679520
Name:KUMAR, DEEPAK (MD)
Entity type:Individual
Prefix:DR
First Name:DEEPAK
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 1:101 MEMORIAL HOSPITAL DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-1784
Mailing Address - Country:US
Mailing Address - Phone:251-414-5900
Mailing Address - Fax:251-281-1169
Practice Address - Street 1:101 MEMORIAL HOSPITAL DR
Practice Address - Street 2:SUITE 200
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-1786
Practice Address - Country:US
Practice Address - Phone:251-414-5900
Practice Address - Fax:251-281-1231
Is Sole Proprietor?:No
Enumeration Date:2008-05-21
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL30757207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51118284OtherBC
AL132556Medicaid
AL102I660453Medicare PIN