1437190261 NPI number — GREGORY MATTHEW BUMP MD

Table of content: GREGORY MATTHEW BUMP MD (NPI 1437190261)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437190261 NPI number — GREGORY MATTHEW BUMP MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BUMP
Provider First Name:
GREGORY
Provider Middle Name:
MATTHEW
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1437190261
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/01/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3459 5TH AVE
Provider Second Line Business Mailing Address:
MUH 9 SOUTH
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15213-3236
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-692-4888
Provider Business Mailing Address Fax Number:
412-647-4050

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3459 FIFTH AVE
Provider Second Line Business Practice Location Address:
MVH 9-SOUTH
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15213
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-692-4888
Provider Business Practice Location Address Fax Number:
412-692-4825
Provider Enumeration Date:
06/10/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  MD428684 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)