Healthcare Provider Details

I. General information

NPI: 1629219969
Provider Name (Legal Business Name): MICHAEL ANTHONY BUMMER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2009
Last Update Date: 12/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BIGELOW SQ SUITE 729
PITTSBURGH PA
15219-3030
US

IV. Provider business mailing address

200 LOTHROP ST FORBES TOWER ROOM 9055
PITTSBURGH PA
15213-2536
US

V. Phone/Fax

Practice location:
  • Phone: 412-281-1360
  • Fax: 412-281-9057
Mailing address:
  • Phone: 412-647-3087
  • Fax: 412-647-4486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD436565
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: