Healthcare Provider Details

I. General information

NPI: 1578024964
Provider Name (Legal Business Name): ANKIT KUMAR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2019
Last Update Date: 02/06/2023
Certification Date: 02/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

GEISINGER MEDICAL CENTER 100 NORTH ACADEMY AVENUE
DANVILLE PA
17822-0001
US

IV. Provider business mailing address

10473 E COBBLESTONE LN
TWINSBURG OH
44087-1469
US

V. Phone/Fax

Practice location:
  • Phone: 570-271-6211
  • Fax:
Mailing address:
  • Phone: 847-890-3386
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number81040-21
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: