Individual
MUKESH KUMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10400 75TH ST, KENOSHA, WI 53142-7884
(262) 948-7030
(262) 948-7033
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01069598A
IN
207Q00000X
Family Medicine Physician
Primary
54937
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100023706
—
WI
05
—
1094633
—
LA
Enumeration date
05/22/2008
Last updated
10/11/2023
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