MEDICARE: SARBJEET S KUMAR M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	MD010445	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2003844	OTHER	TN	BLUE CROSS

General Provider Information

NPI Number	:	1134168982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARBJEET S KUMAR M.D.

Provider Business Mailing Address
First Line	:	322 NORTHCREST DR
Second Line	:
City	:	SPRINGFIELD
State	:	TN
Zip	:	37172-3963
Country	:	US
Telephone Number	:	615-384-2714
Fax Number	:	615-384-6568

Provider Business Practice Location Address
First Line	:	322 NORTHCREST DR
Second Line	:
City	:	SPRINGFIELD
State	:	TN
Zip	:	37172-3963
Country	:	US
Telephone Number	:	615-384-2714
Fax Number	:	615-384-6568

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/06/2006
Last Update Date	:	06/30/2010

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