Healthcare Provider Details

I. General information

NPI: 1336135342
Provider Name (Legal Business Name): UNNI PK KUMAR MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2005
Last Update Date: 04/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6707 POWERS BLVD SUITE 102
PARMA OH
44129-5455
US

IV. Provider business mailing address

6707 POWERS BLVD SUITE 102
PARMA OH
44129-5455
US

V. Phone/Fax

Practice location:
  • Phone: 440-886-5558
  • Fax:
Mailing address:
  • Phone: 440-886-5558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. DONNA REZNIK
Title or Position: OFFICE MANAGER
Credential:
Phone: 440-886-5558