Healthcare Provider Details

I. General information

NPI: 1477133551
Provider Name (Legal Business Name): NIVEDHA KUMAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/12/2021
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1968 PEACHTREE RD NW
ATLANTA GA
30309-1281
US

IV. Provider business mailing address

100 WOODS RD
VALHALLA NY
10595-1530
US

V. Phone/Fax

Practice location:
  • Phone: 404-425-7900
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number111617
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: