MEDICARE: NEELAM B KUMAR MD

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	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	037679	MI

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
2	220014016	OTHER	MI	RR MCR

General Provider Information

NPI Number	:	1447229588
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NEELAM B KUMAR MD

Provider Business Mailing Address
First Line	:	PO BOX 32615
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48232-0615
Country	:	US
Telephone Number	:	313-593-7965
Fax Number	:	313-593-7143

Provider Business Practice Location Address
First Line	:	33155 ANNAPOLIS AVE
Second Line	:	ANNAPOLIS HOSPITAL
City	:	WAYNE
State	:	MI
Zip	:	48184-2405
Country	:	US
Telephone Number	:	734-467-4000
Fax Number	:	734-467-6691

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

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	01/18/2019

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