Provider Demographics
NPI:1285732149
Name:KUMIN, GERALD DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:GERALD
Middle Name:DAVID
Last Name:KUMIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28272 TERRAZZA LN
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-2767
Mailing Address - Country:US
Mailing Address - Phone:239-254-9745
Mailing Address - Fax:239-254-9745
Practice Address - Street 1:28272 TERRAZZA LN
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-2767
Practice Address - Country:US
Practice Address - Phone:239-254-9745
Practice Address - Fax:239-254-9745
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA05115207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00071112AMedicaid
GAD29994Medicare UPIN