Healthcare Provider Details

I. General information

NPI: 1366737405
Provider Name (Legal Business Name): SARAH ELIZABETH BUMPS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2011
Last Update Date: 10/07/2024
Certification Date: 10/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6275 E VIRGINIA BEACH BLVD STE 300
NORFOLK VA
23502-2851
US

IV. Provider business mailing address

6275 E VIRGINIA BEACH BLVD STE 300
NORFOLK VA
23502-2851
US

V. Phone/Fax

Practice location:
  • Phone: 757-466-0089
  • Fax: 757-466-8017
Mailing address:
  • Phone: 757-466-0089
  • Fax: 757-466-8017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMTL-2019-003
License Number StateGU
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberM-2159
License Number StateGU
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number0101252345
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: