Healthcare Provider Details

I. General information

NPI: 1780175844
Provider Name (Legal Business Name): SHARMIL SUMA KUMARAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2018
Last Update Date: 07/12/2024
Certification Date: 07/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

812 GORMAN AVE
ELKINS WV
26241-3181
US

IV. Provider business mailing address

812 GORMAN AVE
ELKINS WV
26241-3181
US

V. Phone/Fax

Practice location:
  • Phone: 304-636-3300
  • Fax: 304-637-3441
Mailing address:
  • Phone: 304-637-3300
  • Fax: 304-637-3441

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 TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number33621
License Number StateWV
# 3
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number33621
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: