Individual
DR. KUMAR BOBBA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1900 E MAIN ST, DANVILLE, IL 61832
(217) 554-3000
(217) 554-4807
Mailing address
1900 E MAIN ST, DANVILLE, IL 61832-5100
(217) 554-3000
(217) 554-4807
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
01076077A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01076077A
—
IN
01
—
060061599
MEDICARE RAILROAD
—
Enumeration date
01/10/2006
Last updated
10/22/2019
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