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Individual

KRISHNAN S KUMAR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1900 A OPITZ BLVD, WOODRIDGE, VA 22191
(703) 494-0912
(240) 337-2652
Mailing address
1900 A OPITZ BLVD, WOODRIDGE, VA 22191
(703) 494-0912
(240) 337-2652

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101042377
VA
208D00000X
General Practice Physician
0101042377
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6729436
VA
05
6729444
VA
Enumeration date
04/20/2006
Last updated
10/04/2016
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