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Individual

BIRENDRA S KUMAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1230 E MAIN ST, MANKATO CLINIC AT MAIN STREET, MANKATO, MN 56001-5066
(507) 625-1811
Mailing address
110105 PIONEER W TRL 302, CHASKA, MN 55318-2680
(952) 361-5800
(952) 361-5858

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
39113
MN
207RH0003X
Hematology & Oncology Physician
Primary
39113
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0593046
IA
01
115710
UCARE
MN
05
256514500
MN
01
335L2KU
BCBS
MN
01
3600541
MEDICA
MN
01
41084933956001C219
CHAMPUS
01
773738
AMERICAS PPO
MN
01
HP21623
HEALTH PARTNERS
MN
01
NA2951011969
PREFERRED ONE
MN
01
P00211303
RR MEDICARE
Enumeration date
01/10/2006
Last updated
09/09/2016
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