Provider Demographics
NPI:1083827018
Name:ABHISHEK, KUMAR (MD)
Entity type:Individual
Prefix:
First Name:KUMAR
Middle Name:
Last Name:ABHISHEK
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 1:8262 ATLEE RD STE 201
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23116-1816
Mailing Address - Country:US
Mailing Address - Phone:804-764-7220
Mailing Address - Fax:804-764-6212
Practice Address - Street 1:8266 ATLEE RD
Practice Address - Street 2:SUITE 225
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23116-1804
Practice Address - Country:US
Practice Address - Phone:804-764-7220
Practice Address - Fax:804-764-6212
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101241559207R00000X
PAMD433581207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1083827018Medicaid
VAC06115OtherGROUP PTAN
VAC06778OtherGROUP PTAN
VAC06778OtherGROUP PTAN