Doctor Name: | PANKAJ KUMAR |
NPI Number: | 1285920512 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 2014-01466 |
Business Practice Address: | Medical Center Blvd Winston Salem, NC - 271570001 |
Business Phone Number: | 3367162255 |
Business Fax Number: | |
Mailing Address: | Medical Center Blvd, WINSTON SALEM |
State: | NC |
Postal Code: | 271570001 |
Phone Number: | 3367162255 |
Fax Number: | |
NPI Enumeration Date: | 06/24/2011 |
NPI Last Update Date: | 12/19/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 2014-01466 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |