Provider Demographics
NPI:1386751048
Name:ROBERT N. DUMIN, M.D.
Entity type:Organization
Organization Name:ROBERT N. DUMIN, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:NEIL
Authorized Official - Last Name:DUMIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-593-2728
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2013-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10000743174400000X, 261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE000109901Medicaid
DEB66508Medicare UPIN
DE000109901Medicaid