Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 01028111 | IN |
NPI | 1003842253 |
---|---|
Provider Name | Karen L. Bumb |
First Address | Indianapolis, IN 46207-7232 |
Second Address | Indianapolis, IN 46202-1239 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2006 |
Last Update Date | 13/08/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100071980 | (05) | IN |
D95395 | (02) | IN |