Healthcare Provider Details

I. General information

NPI: 1740267244
Provider Name (Legal Business Name): SANJAY KUMAR D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2005
Last Update Date: 11/11/2025
Certification Date: 11/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5319 HOAG DR SUITE 100
SHEFFIELD VILLAGE OH
44035-1494
US

IV. Provider business mailing address

5319 HOAG DR STE 100
SHEFFIELD VILLAGE OH
44035-1492
US

V. Phone/Fax

Practice location:
  • Phone: 440-930-6015
  • Fax: 440-930-6094
Mailing address:
  • Phone: 440-930-6015
  • Fax: 440-930-6094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number34008864
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number34.008864
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: