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Individual

DR. PRAVEEN KUMAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2500 N. STATE STREET, UNIV OF MS MED CTR., NEWBORN MEDICINE, JACKSON, MS 39216-4505
(601) 815-7158
Mailing address
2500 N. STATE STREET, UNIV OF MS MED CTR., NEWBORN MEDICINE, JACKSON, MS 39216-4505
(601) 815-7158

Taxonomy

Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
036089967
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036089967
IL
Enumeration date
05/19/2006
Last updated
01/02/2014
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