MEDICARE: SHAILENDRA 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	174400000X	Specialist	D0018198	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	M05021	OTHER	MD	STATE CDS NUMBER
2	D0063012	OTHER	MD	LIC NUMBER
3	061985	OTHER	MD	USMLE / ECFMG
4	D0018198	OTHER	MD	LICENCE NUMBER
5	MD6694	OTHER	DC	LICENCE NUMBER

General Provider Information

NPI Number	:	1487675492
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHAILENDRA KUMAR M.D.

Provider Business Mailing Address
First Line	:	6510 KENILWORTH AVE
Second Line	:	2200
City	:	RIVERDALE
State	:	MD
Zip	:	20737-1339
Country	:	US
Telephone Number	:	301-699-9513
Fax Number	:	301-864-8565

Provider Business Practice Location Address
First Line	:	6510 KENILWORTH AVE
Second Line	:	2200
City	:	RIVERDALE
State	:	MD
Zip	:	20737-1339
Country	:	US
Telephone Number	:	301-699-9513
Fax Number	:	301-864-8565

Authorized Official
Title or Position	:	CHAIRMAN
Name	:	DR. SHAILENDRA KUMAR
Credential	:	M.D.
Telephone Number	:	301-699-9513

Provider Enumeration Date	:	07/22/2006
Last Update Date	:	03/07/2023

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