1902924327 NPI number — ROBERT R. BUMANN, M.D., P.C.

Table of content: (NPI 1902924327)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902924327 NPI number — ROBERT R. BUMANN, M.D., P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROBERT R. BUMANN, M.D., P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1902924327
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/24/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 629
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHRISTIANSTED
Provider Business Mailing Address State Name:
VI
Provider Business Mailing Address Postal Code:
00821-0629
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
340-778-6311
Provider Business Mailing Address Fax Number:
340-713-1870

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4007 ESTATE DIAMOND RUBY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ST.CROIX
Provider Business Practice Location Address State Name:
VI
Provider Business Practice Location Address Postal Code:
00820
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
340-778-6311
Provider Business Practice Location Address Fax Number:
340-713-1870
Provider Enumeration Date:
03/26/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BUMANN
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
R.
Authorized Official Title or Position:
M.D.
Authorized Official Telephone Number:
340-778-6311

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X , with the licence number:  1210 , registered in the state of VI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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