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General NPI Number Information
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NPI Number | 1013404532
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Entity Type | Individual
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Provider Name | LUKAS DAVID DUMBERGER MD
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Gender | Male
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Dates
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Enumeration Date | 04/19/2018
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 6035 FAIRVIEW RD
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City | CHARLOTTE
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State | NC
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Zip | 28210-3256
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Country | US
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Telephone | 704-838-8493
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Fax | 704-838-8494
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Provider Business Mailing Address
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Address Line | 6035 FAIRVIEW RD
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City | CHARLOTTE
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State | NC
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Zip | 28210-3256
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Country | US
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Telephone | 704-838-8493
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Fax | 704-838-8494
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YX0007X
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Taxonomy Name | Plastic Surgery within the Head & Neck (Otolaryngology) Physician
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License Number | MD474217
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 2024-01326
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License Number State | NC
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