Provider Demographics
NPI:1427463058
Name:KUMAR, ABHISHEK (MD)
Entity type:Individual
Prefix:DR
First Name:ABHISHEK
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 1:1500 LOCUST ST
Mailing Address - Street 2:APT 2218
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-4329
Mailing Address - Country:US
Mailing Address - Phone:281-728-2784
Mailing Address - Fax:
Practice Address - Street 1:1500 LOCUST ST
Practice Address - Street 2:APT 2218
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-4329
Practice Address - Country:US
Practice Address - Phone:281-728-2784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-23
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4563882085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology