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General NPI Number Information
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NPI Number | 1821068107
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Entity Type | Individual
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Provider Name | BRUCE JAMES SUMLIN M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/26/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 6418 REISTERSTOWN RD
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City | BALTIMORE
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State | MD
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Zip | 21215-2308
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Country | US
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Telephone | 410-318-8855
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Fax | 410-764-3229
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Provider Business Mailing Address
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Address Line | 200 BANNING ST SUITE 130
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City | DOVER
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State | DE
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Zip | 19904-3485
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Country | US
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Telephone | 302-678-1700
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Fax | 302-678-2330
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MD454657
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | C1-0008619
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License Number State | DE
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Taxonomy #3
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | D0067113
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License Number State | MD
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