Individual
KUMARA SIDHARTHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
495 STATION AVE, SOUTH YARMOUTH, MA 02664-1218
(508) 778-4777
(508) 771-9555
Mailing address
297 NORTH ST STE 221, HYANNIS, MA 02601-5133
(508) 862-7777
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
215838
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0183610
—
MA
01
—
043369730
PRIVATE HEALTHCARE SYSTEM
—
01
—
215838
TUFTS
—
01
—
694622
HARVARD PILGRIM
—
01
—
7390460
AETNA
—
01
—
J25418
BLUE CROSS
—
Enumeration date
07/25/2006
Last updated
06/18/2019
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