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General NPI Number Information
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NPI Number | 1982690327
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Entity Type | Individual
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Provider Name | MARK DUMAIS M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/21/2005
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Last Update Date | 06/04/2012
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Provider Practice Location Address
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Address Line | 500 CHARLES ST
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City | LA PLATA
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State | MD
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Zip | 20646-5931
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Country | US
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Telephone | 301-609-4857
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Fax | 301-609-4105
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Provider Business Mailing Address
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Address Line | 500 CHARLES ST
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City | LA PLATA
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State | MD
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Zip | 20646-5931
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Country | US
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Telephone | 301-609-4857
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Fax | 301-609-4105
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | D0053813
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 2083P0011X
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Taxonomy Name | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
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License Number | D0053813
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License Number State | MD
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