Individual provider Active NPI

Suresh Kumar

  • Pharmacist
  • Detroit, MI
National Provider Identifier
1821629619
Registry record updated Jan 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302039710 Issued in MI
Practice address
19900 Van Dyke St
Detroit, MI 48234-3212
Phone
(313) 368-3800
NPI assigned
Jan 30, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302039710 MI Primary

Addresses

Primary practice location

19900 Van Dyke St
Detroit, MI 48234-3212

Mailing address

2355 Dorchester Dr N Apt 202
Troy, MI 48084-3728

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5302039710MIMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1580342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580342400000",
    "number": "1821629619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2355 DORCHESTER DR N APT 202",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480843728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19900 VAN DYKE ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482343212",
            "telephone_number": "313-368-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUMAR",
        "first_name": "SURESH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-30",
        "last_updated": "2020-01-30",
        "certification_date": "2020-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MI",
            "license": "5302039710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.