Healthcare Provider Details

I. General information

NPI: 1841366135
Provider Name (Legal Business Name): ROMA V GUMBS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 08/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2041 GEORGIA AVE NW
WASHINGTON DC
20060-0001
US

IV. Provider business mailing address

2024 GEORGIA AVE NW
WASHINGTON DC
20001-3027
US

V. Phone/Fax

Practice location:
  • Phone: 202-865-1571
  • Fax: 202-865-3285
Mailing address:
  • Phone: 202-595-3223
  • Fax: 202-332-2985

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD12687
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: