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General NPI Number Information
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NPI Number | 1386380079
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Entity Type | Individual
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Provider Name | VIKASH KUMAR
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Gender | Male
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Dates
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Enumeration Date | 05/06/2022
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 205 N EAST AVE, JACKSON
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City | JACKSON
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State | MI
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Zip | 49201
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Country | US
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Telephone | 517-205-1328
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Fax |
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Provider Business Mailing Address
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Address Line | 37000 GRAND RIVER AVE STE 310
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City | FARMINGTON HILLS
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State | MI
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Zip | 48335-2868
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Country | US
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Telephone | 248-536-2127
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Fax | 248-893-6952
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301514014
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License Number State | MI
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