MEDICARE: DR. SANJIV 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	207L00000X	Anesthesiology Physician	71578	MA

General Provider Information

NPI Number	:	1295725778
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SANJIV KUMAR M.D.

Provider Business Mailing Address
First Line	:	133 OLD ROAD TO 9 ACRE COR
Second Line	:	EMERSON HOSPITAL ,DEPT. OF ANESTHESIA
City	:	CONCORD
State	:	MA
Zip	:	01742-4159
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	133 ORNAC
Second Line	:
City	:	CONCORD
State	:	MA
Zip	:	01742-4159
Country	:	US
Telephone Number	:	978-287-3162
Fax Number	:

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

Provider Enumeration Date	:	10/25/2005
Last Update Date	:	11/24/2008

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