Provider Demographics
NPI:1104052430
Name:KUMAR, MOSES (MD)
Entity type:Individual
Prefix:DR
First Name:MOSES
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 1:160 SMOKESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:REINHOLDS
Mailing Address - State:PA
Mailing Address - Zip Code:17569-9806
Mailing Address - Country:US
Mailing Address - Phone:718-612-4670
Mailing Address - Fax:
Practice Address - Street 1:401 LIBERTY AVE STE 2000
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15222-1029
Practice Address - Country:US
Practice Address - Phone:412-230-8200
Practice Address - Fax:412-202-8638
Is Sole Proprietor?:No
Enumeration Date:2009-06-01
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43011164762085R0202X, 2085R0204X
KY519542085R0202X, 2085R0204X
OH35.1359102085R0204X, 2085R0202X
PAMD4425752085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1104052430Medicaid
PA1025895070002Medicaid
IN300025096Medicaid
OH0263738Medicaid
VA1104052430Medicaid
KY7100578440Medicaid