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General NPI Number Information
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NPI Number | 1285906420
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Entity Type | Organization
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Legal Business Name | ALLEN DUMONT MD PC
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Dates
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Enumeration Date | 02/03/2012
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Last Update Date | 11/05/2013
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Provider Practice Location Address
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Address Line | 911 BROWN ST
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City | ANN ARBOR
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State | MI
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Zip | 48104-3203
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Country | US
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Telephone | 734-769-3702
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Fax |
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Provider Business Mailing Address
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Address Line | 911 BROWN ST
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City | ANN ARBOR
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State | MI
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Zip | 48104-3203
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Country | US
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Telephone | 734-769-3702
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALLEN DUMONT
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Credential | MD
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Telephone | 734-769-3702
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080A0000X
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Taxonomy Name | Pediatric Adolescent Medicine Physician
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License Number | 4301027689
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License Number State | MI
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