Individual
MR. AMRENDRA KUMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1130 HWY 9 BYPASS W, LANCASTER, SC 29720
(803) 285-2225
Mailing address
1130 HWY 9 BYPASS, LANCASTER, SC 29720
(803) 285-2225
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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