Healthcare Provider Details

I. General information

NPI: 1528389012
Provider Name (Legal Business Name): GEORGE KUM-NJI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2010
Last Update Date: 11/07/2025
Certification Date: 11/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1004 NORTH ST
JACKSON MS
39202-2433
US

IV. Provider business mailing address

PO BOX 22239
NEW YORK NY
10087-0001
US

V. Phone/Fax

Practice location:
  • Phone: 201-654-6397
  • Fax: 201-608-9241
Mailing address:
  • Phone: 201-654-6397
  • Fax: 201-608-9241

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number30872
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: