Healthcare Provider Details

I. General information

NPI: 1447043518
Provider Name (Legal Business Name): ATEESH KUMAR M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2025
Last Update Date: 08/29/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 N EAST AVE 2ND FL CAB BLDG HENRY FORD JACKSON HOSPI
JACKSON MI
49201
US

IV. Provider business mailing address

209 W LOUIS GLICK HWY APARTMENT 3E JACKSON MICHIGAN
JACKSON MI
49201
US

V. Phone/Fax

Practice location:
  • Phone: 517-205-7116
  • Fax: 517-205-7050
Mailing address:
  • Phone: 517-205-7116
  • Fax: 517-205-7050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: