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Individual
MR. AMRENDRA KUMAR
Active
Individual
MR. AMRENDRA KUMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
29114
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22N33N45
SC SUBSTANCE CONTROLLED
SC
01
—
29114
SC MEDICAL LICENSE
SC
01
—
BK9868831
CONTROLLED SUBSTANCE
SC
Enumeration date
10/31/2006
Last updated
07/08/2007
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