MEDICARE: KUMAR MANAGEMENT GROUP, LLC

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	207RC0000X	Cardiovascular Disease Physician

General Provider Information

NPI Number	:	1891156311
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KUMAR MANAGEMENT GROUP, LLC

Provider Business Mailing Address
First Line	:	401 N BUFFALO DR
Second Line	:	100
City	:	LAS VEGAS
State	:	NV
Zip	:	89145-0310
Country	:	US
Telephone Number	:	702-853-5681
Fax Number	:	702-675-6971

Provider Business Practice Location Address
First Line	:	401 N BUFFALO DR
Second Line	:	100
City	:	LAS VEGAS
State	:	NV
Zip	:	89145-0310
Country	:	US
Telephone Number	:	702-853-5681
Fax Number	:	702-675-6971

Authorized Official
Title or Position	:	CEO/OWNER
Name	:	VIJAY KUMAR KITTUSAMY
Credential	:
Telephone Number	:	702-853-5681

Provider Enumeration Date	:	03/10/2016
Last Update Date	:	03/10/2016

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