Healthcare Provider Details

I. General information

NPI: 1730865239
Provider Name (Legal Business Name): SAHLISH KUMAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2023
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 MICHIGAN ST NE STE 4200
GRAND RAPIDS MI
49503-2559
US

IV. Provider business mailing address

25 MICHIGAN ST NE STE 4200
GRAND RAPIDS MI
49503-2559
US

V. Phone/Fax

Practice location:
  • Phone: 616-267-9150
  • Fax: 616-267-1408
Mailing address:
  • Phone: 616-267-9150
  • Fax: 616-267-1408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberME179243
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number4301517676
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: