Individual
DR. VIJAY KUMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1701 E COLLEGE AVE, BLOOMINGTON, IL 61704-2100
(309) 664-3800
(309) 664-3461
Mailing address
1701 E COLLEGE AVE, BLOOMINGTON, IL 61704-2100
(309) 664-3800
(309) 664-3461
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
4301089181
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1000104
HEALTHPLUS OF MICHIGAN
MI
05
—
1992858617
—
MI
01
—
381870664
TAX ID
MI
01
—
700G360210
BCBSM GROUP PIN
—
01
—
7820867
AETNA
—
01
—
VK089181
LICENSE
MI
Enumeration date
01/18/2007
Last updated
05/25/2022
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