Healthcare Provider Details
I. General information
NPI: 1558522003
Provider Name (Legal Business Name): PARVEEN KUMAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/18/2008
Last Update Date: 06/07/2024
Certification Date: 06/07/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1575 BEAM AVE
MAPLEWOOD MN
55109-1126
US
IV. Provider business mailing address
5608 17TH AVE NW STE 537
SEATTLE WA
98107-5232
US
V. Phone/Fax
- Phone: 651-232-7000
- Fax:
- Phone: 607-846-8041
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | MD447163 |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | 64038 |
| License Number State | MN |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | 4301115459 |
| License Number State | MI |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | MD447163 |
| License Number State | PA |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | 268250 |
| License Number State | NY |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | 60849418 |
| License Number State | WA |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | 174-320 |
| License Number State | WI |
| # 8 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | 64038 |
| License Number State | MN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: