Healthcare Provider Details

I. General information

NPI: 1356362792
Provider Name (Legal Business Name): MADHURESH KUMAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 E LOCKLING ST
BROOKFIELD MO
64628-2337
US

IV. Provider business mailing address

5709 W 131ST ST
LEAWOOD KS
66209-3638
US

V. Phone/Fax

Practice location:
  • Phone: 660-258-2222
  • Fax: 866-368-6349
Mailing address:
  • Phone: 772-708-4604
  • Fax: 772-404-7939

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number20190008703
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberCDR.0002580
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberME74870
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number44949
License Number StateGA
# 5
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2019008703
License Number StateMO
# 6
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number01078179A
License Number StateIN
# 7
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number04-41167
License Number StateKS
# 8
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number66908
License Number StateWI
# 9
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number63310
License Number StateMN
# 10
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number343364
License Number StateLA
# 11
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number2019008703
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: