Individual
GAGAN KUMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
743 SPRING ST NE, GAINESVILLE, GA 30501-3715
(414) 688-4827
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
72702
GA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
72702
GA
207RP1001X
Pulmonary Disease Physician
72702
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34978300
—
WI
Enumeration date
10/20/2006
Last updated
11/17/2020
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