Healthcare Provider Details

I. General information

NPI: 1780152405
Provider Name (Legal Business Name): FATIMA DUMBUYA MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/12/2018
Last Update Date: 11/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 S BRADFORD ST STE 7
DOVER DE
19904-4153
US

IV. Provider business mailing address

1001 S BRADFORD ST STE 7
DOVER DE
19904-4153
US

V. Phone/Fax

Practice location:
  • Phone: 302-678-4558
  • Fax: 302-678-4577
Mailing address:
  • Phone: 302-678-4558
  • Fax: 302-678-4577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number2018608657
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: