Individual
SRIDIVYA KUMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
200 E 80TH PL UNIT 2, MERRILLVILLE, IN 46410-5671
(219) 472-0379
(219) 472-0491
Mailing address
PO BOX 3877, JOLIET, IL 60434-3877
(815) 741-6830
(815) 741-6832
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
01073307A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201204760
—
IN
Enumeration date
04/09/2008
Last updated
10/31/2022
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