Healthcare Provider Details

I. General information

NPI: 1922328673
Provider Name (Legal Business Name): GREGORY DUMA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2010
Last Update Date: 10/13/2021
Certification Date: 10/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 PRINCETON RD
HAMILTON OH
45011
US

IV. Provider business mailing address

118 W 5TH ST
COVINGTON KY
41011-1481
US

V. Phone/Fax

Practice location:
  • Phone: 513-868-9999
  • Fax: 513-868-8898
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VB0002X
TaxonomyObesity Medicine (Obstetrics & Gynecology) Physician
License Number28974
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: