Healthcare Provider Details

I. General information

NPI: 1427693415
Provider Name (Legal Business Name): ERIK GUMBS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ERIQUE GUMBS NP-C

II. Dates (important events)

Enumeration Date: 11/13/2019
Last Update Date: 11/27/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 RIVER RD
DOVER DE
19901-3753
US

IV. Provider business mailing address

11 BLACKBIRD CT
NEWARK DE
19702-8633
US

V. Phone/Fax

Practice location:
  • Phone: 303-857-5060
  • Fax: 302-857-5061
Mailing address:
  • Phone: 302-229-2976
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberLP-0000324
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: