Healthcare Provider Details

I. General information

NPI: 1588243372
Provider Name (Legal Business Name): ARVIND SENTHIL KUMAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/07/2021
Last Update Date: 08/23/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 RIVERSTONE TER STE 101
CANTON GA
30114-5327
US

IV. Provider business mailing address

145 RIVERSTONE TER STE 101
CANTON GA
30114-5327
US

V. Phone/Fax

Practice location:
  • Phone: 770-450-4807
  • Fax:
Mailing address:
  • Phone: 770-450-4807
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number111170
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: