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NPI Code Detail

MEDICARE: MR. MARTIAL ANDREW DUMINY PA

MEDICARE: MR. MARTIAL ANDREW DUMINY PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AS0400XSurgical Physician AssistantPA 11291CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PA 11291OTHERCAPA LICENSE

General Provider Information

NPI Number : 1750459749
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MARTIAL ANDREW DUMINY PA
Provider Business Mailing Address
First Line : 6600 BRUCEVILLE RD
Second Line :
City : SACRAMENTO
State : CA
Zip : 95823-4671
Country : US
Telephone Number : 916-688-6276
Fax Number :
Provider Business Practice Location Address
First Line : 6600 BRUCEVILLE RD
Second Line :
City : SACRAMENTO
State : CA
Zip : 95823-4671
Country : US
Telephone Number : 916-688-6276
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2006
Last Update Date : 07/08/2007

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