MEDICARE: MR. FNU KAMAL KUMAR

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1174312888
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. FNU KAMAL KUMAR

Provider Business Mailing Address
First Line	:	2401 W. BELVEDERE AVE BALTIMORE MD, 21215
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21215
Country	:	US
Telephone Number	:	410-601-4164
Fax Number	:

Provider Business Practice Location Address
First Line	:	2401 W. BELVEDERE AVE BALTIMORE MD, 21215
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21215
Country	:	US
Telephone Number	:	410-601-4164
Fax Number	:

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

Provider Enumeration Date	:	05/01/2025
Last Update Date	:	01/13/2026

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