MEDICARE: RAKESH KUMAR MD PC

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	208D00000X	General Practice Physician	022807	GA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	020000895	OTHER	GA	MEDICARE RAILROAD

Other Identifiers

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

General Provider Information

NPI Number	:	1477733491
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAKESH KUMAR MD PC

Provider Business Mailing Address
First Line	:	PO BOX 4150
Second Line	:
City	:	EATONTON
State	:	GA
Zip	:	31024-4150
Country	:	US
Telephone Number	:	706-485-2621
Fax Number	:

Provider Business Practice Location Address
First Line	:	123 SPARTA HWY
Second Line	:
City	:	EATONTON
State	:	GA
Zip	:	31024-6093
Country	:	US
Telephone Number	:	707-485-2621
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT/OWNER
Name	:	DR. RAKESH KUMAR
Credential	:	M.D.
Telephone Number	:	707-485-2621

Provider Enumeration Date	:	11/07/2007
Last Update Date	:	02/28/2008

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