MEDICARE: MR. RAVI 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	174400000X	Specialist		IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	146668	OTHER		HEALTHLINK ID

General Provider Information

NPI Number	:	1851397319
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RAVI KUMAR MD

Provider Business Mailing Address
First Line	:	PO BOX 16068
Second Line	:
City	:	HIGH POINT
State	:	NC
Zip	:	27261-6068
Country	:	US
Telephone Number	:	888-447-7220
Fax Number	:	336-884-1643

Provider Business Practice Location Address
First Line	:	211 S 3RD ST
Second Line	:
City	:	BELLEVILLE
State	:	IL
Zip	:	62220-1915
Country	:	US
Telephone Number	:	618-234-2120
Fax Number	:	618-222-4614

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

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	07/09/2007

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Directions to “ MR. RAVI KUMAR MD” Practice Location

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