Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | 036-115393 | IL |
NPI | 1063682086 |
---|---|
Provider Name | Munish Kumar |
First Address | Urbana, IL 61801 |
Second Address | Normal, IL 61761-3558 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/03/2008 |
Last Update Date | 24/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036115393 | (05) | IL |