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NPI Code Detail

MEDICARE: DR. GERALD W CORUM DMD

MEDICARE:  DR. GERALD W CORUM  DMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry4793FL

General Provider Information

NPI Number : 1326172602
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GERALD W CORUM DMD
Provider Business Mailing Address
First Line : 620 W STATE ROAD 434
Second Line :
City : WINTER SPRINGS
State : FL
Zip : 32708-5330
Country : US
Telephone Number : 407-327-0731
Fax Number :
Provider Business Practice Location Address
First Line : 620 W STATE ROAD 434
Second Line :
City : WINTER SPRINGS
State : FL
Zip : 32708-5330
Country : US
Telephone Number : 407-327-0731
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2007
Last Update Date : 07/08/2007

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Directions to “ DR. GERALD W CORUM DMD” Practice Location

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