Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | SC004164R | PA |
NPI | 1609879816 |
---|---|
Provider Name | Dr. Duane Dumm |
First Address | Altoona, PA 16601-1705 |
Second Address | Northern Cambria, PA 15714-0000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2005 |
Last Update Date | 28/11/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0016238800002 | (05) | PA |
U52198 | (02) | PA |