Individual
MR. PANKAJ KUMAR
Active
Individual
MR. PANKAJ KUMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01040839
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000109079
BLUE SHIELD-REID HOSPITAL
IN
01
—
000000347061
ANTHEM BCBS PROVIDER PIN
IN
05
—
100257230
—
IN
05
—
100257230A
—
IN
01
—
110058501
RR MEDICARE
IN
01
—
1639279094
PECOS
IN
01
—
903830Y
REID HOSPITAL-EKG
IN
Enumeration date
09/25/2006
Last updated
05/14/2021
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