Individual
MR. PANKAJ KUMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1100 REID PKWY, RICHMOND, IN 47374-1157
(765) 983-3492
(765) 983-7958
Mailing address
1100 REID PARKWAY, MEDICAL STAFF SERVICE, RICHMOND, IN 47374
(765) 935-5331
(765) 983-3219
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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