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Individual

MRS. SUPRIYA SHAMSUNDER KUMAR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
330 N WABASH AVE, SUITE 400, MARION, IN 46952-2780
(765) 660-7680
(765) 671-3155
Mailing address
330 NORTH WABASH AVE, SUITE G20, MARION, IN 46952-2600
(765) 660-7600
(765) 165-1731

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
01062995A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000498499
ANTHEM
05
200845260
IN
Enumeration date
10/26/2005
Last updated
10/19/2020
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