MEDICARE: DR. DEEPAK 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	208C00000X	Colon & Rectal Surgery Physician	35100257K	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154324747
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEEPAK KUMAR M.D.

Provider Business Mailing Address
First Line	:	5932 SPRINGBORO PIKE
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45449-3250
Country	:	US
Telephone Number	:	937-435-8663
Fax Number	:	937-435-8966

Provider Business Practice Location Address
First Line	:	5932 SPRINGBORO PIKE
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45449-3250
Country	:	US
Telephone Number	:	937-435-8663
Fax Number	:	937-435-8966

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2005
Last Update Date	:	03/25/2019

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