Individual
DR. PREM KUMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3300 GREYSTONE WAY, VALDOSTA, GA 31605-1096
(229) 247-7700
(229) 247-2666
Mailing address
3300 GREYSTONE WAY, VALDOSTA, GA 31605-1096
(229) 247-7700
(229) 247-2666
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
466691
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00814107I
—
GA
05
—
00814107J
—
GA
Enumeration date
12/08/2005
Last updated
03/20/2010
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