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NPI Code Detail

MEDICARE: SHIVESH SRI KUMAR M.D.

MEDICARE:   SHIVESH SRI 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
1207Q00000XFamily Medicine Physician14464NV

General Provider Information

NPI Number : 1235373564
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHIVESH SRI KUMAR M.D.
Provider Business Mailing Address
First Line : 6090 S FORT APACHE RD STE 140
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-5618
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6090 S FORT APACHE RD STE 140
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-5618
Country : US
Telephone Number : 725-735-5407
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/30/2009
Last Update Date : 09/22/2023

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Directions to “ SHIVESH SRI KUMAR M.D.” Practice Location

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