MEDICARE: SUBHASH KUMAR M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician

General Provider Information

NPI Number	:	1093769507
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUBHASH KUMAR M.D.

Provider Business Mailing Address
First Line	:	1656 13TH AVE
Second Line	:
City	:	HUNTINGTON
State	:	WV
Zip	:	25701-3829
Country	:	US
Telephone Number	:	304-529-2090
Fax Number	:	304-522-2658

Provider Business Practice Location Address
First Line	:	1656 13TH AVE
Second Line	:
City	:	HUNTINGTON
State	:	WV
Zip	:	25701-3829
Country	:	US
Telephone Number	:	304-529-2090
Fax Number	:	304-522-2658

Authorized Official
Title or Position	:	OWNER
Name	:	SUBHASH KUMAR
Credential	:	M.D.
Telephone Number	:	304-529-2090

Provider Enumeration Date	:	05/20/2006
Last Update Date	:	08/22/2020

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