Healthcare Provider Details

I. General information

NPI: 1487849725
Provider Name (Legal Business Name): ANDREW ALEXANDER GUMBS M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2007
Last Update Date: 04/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 COTTMAN AVE FOX CHASE CANCER CENTER
PHILADELPHIA PA
19111-2434
US

IV. Provider business mailing address

333 COTTMAN AVE
PHILADELPHIA PA
19111-2434
US

V. Phone/Fax

Practice location:
  • Phone: 215-728-6900
  • Fax:
Mailing address:
  • Phone: 215-728-6900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License NumberMD435646
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: