Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 01068420A | IN |
N | 207QA0401X | Family Doctor - Addiction Medicine | 01068420A | IN |
NPI | 1043475445 |
---|---|
Provider Name | Dr. David Cummins |
First Address | Valparaiso, IN 46383-9181 |
Second Address | Valparaiso, IN 46383-8947 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2008 |
Last Update Date | 29/10/2015 |