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General NPI Number Information
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NPI Number | 1972808244
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Entity Type | Individual
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Provider Name | LUMINITA DUMITRU PA
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Gender | Female
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Dates
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Enumeration Date | 01/18/2011
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Last Update Date | 09/10/2021
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Provider Practice Location Address
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Address Line | 101 COMMERCE PL STE 1
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City | BARNESVILLE
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State | GA
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Zip | 30204-1680
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Country | US
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Telephone | 770-358-4408
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Fax |
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Provider Business Mailing Address
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Address Line | 643 MAIN ST
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City | PALMETTO
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State | GA
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Zip | 30268-1138
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Country | US
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Telephone | 561-221-4712
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Fax |
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA9105713
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License Number State | FL
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