Individual
DR. PREM C KUMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
215 S POWER RD, 102, MESA, AZ 85206
(480) 985-9005
(480) 649-3685
Mailing address
215 S POWER RD, SUITE 102, MESA, AZ 85206-5235
(480) 985-9005
(480) 396-9974
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
12854
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
215104
—
AZ
01
—
AZ0002430
BCBS
AZ
Enumeration date
04/18/2006
Last updated
04/29/2010
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