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General NPI Number Information
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NPI Number | 1477691079
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Entity Type | Individual
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Provider Name | LESLIE ADJETEY KUMA M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/03/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2200 GRANT ST STE 201
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City | GARY
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State | IN
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Zip | 46404-3439
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Country | US
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Telephone | 219-944-0300
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Fax |
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Provider Business Mailing Address
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Address Line | 8018 S EVANS AVE APT 3W
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City | CHICAGO
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State | IL
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Zip | 60619-3927
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Country | US
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Telephone | 630-926-6825
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Fax |
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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 | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 01062927A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number |
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License Number State | IL
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