Provider Demographics
NPI:1386380079
Name:KUMAR, VIKASH
Entity type:Individual
Prefix:
First Name:VIKASH
Middle Name:
Last Name:KUMAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DETROIT EDUCATION AND RESEARCH GRADUATE MEDICAL EDUCATI
Mailing Address - Street 2:42001 ST. ANTOINE ST., 9C-4HC
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48201
Mailing Address - Country:US
Mailing Address - Phone:313-745-5146
Mailing Address - Fax:313-993-8502
Practice Address - Street 1:DETROIT EDUCATION AND RESEARCH GRADUATE MEDICAL EDUCATI
Practice Address - Street 2:42001 ST. ANTOINE ST., 9C-4HC
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48201
Practice Address - Country:US
Practice Address - Phone:313-745-5146
Practice Address - Fax:313-993-8501
Is Sole Proprietor?:No
Enumeration Date:2022-05-06
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program