Healthcare Provider Details

I. General information

NPI: 1013553015
Provider Name (Legal Business Name): PRIYANKA KUMAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/25/2019
Last Update Date: 09/06/2026
Certification Date: 09/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5530 WISCONSIN AVE STE 730
CHEVY CHASE MD
20815-4447
US

IV. Provider business mailing address

5530 WISCONSIN AVE STE 730
CHEVY CHASE MD
20815-4447
US

V. Phone/Fax

Practice location:
  • Phone: 301-951-2400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberD0106854
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: