Individual
ANUSHA KUMBAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4300 CASCADE RD SE, GRAND RAPIDS, MI 49546
(616) 252-1500
(616) 252-1599
Mailing address
5900 BYRON CENTER AVE SW, MEDICAL ADMINISTRATION, WYOMING, MI 49519-9606
(616) 252-3243
(616) 252-0260
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125065101
IL
207R00000X
Internal Medicine Physician
Primary
4301111796
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1083020036
—
MI
Enumeration date
07/09/2014
Last updated
08/01/2018
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