Individual
DR. KEVIN FRANCIS CUMPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
621 MEMORIAL DR STE 624, SOUTH BEND, IN 46601-1063
(574) 647-8177
(574) 647-8536
Mailing address
710 N NILES AVE, SOUTH BEND, IN 46617-1924
(574) 647-1610
(574) 237-6069
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
01080202A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
236040284
MEDICARE PTAN
IN
01
—
261970098
MEDICARE PTAN
IN
05
—
300013875
—
IN
Enumeration date
06/11/2013
Last updated
03/31/2021
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