Provider Demographics
NPI:1124138250
Name:DUMIN, ROBERT NEIL (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:NEIL
Last Name:DUMIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1504 TURKEY RUN RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-3918
Mailing Address - Country:US
Mailing Address - Phone:302-593-2728
Mailing Address - Fax:302-689-4644
Practice Address - Street 1:1504 TURKEY RUN RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-3918
Practice Address - Country:US
Practice Address - Phone:302-593-2728
Practice Address - Fax:302-689-4644
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2013-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC100007432084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE000109901Medicaid
DE137780Medicare ID - Type UnspecifiedMEDICARE NUMBER
DE000109901Medicaid