MEDICARE: DOUGLAS M CUMMINGS M.D.

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
1	208800000X	Urology Physician	4301059109	MI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00227822	OTHER	MI	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1851375935
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOUGLAS M CUMMINGS M.D.

Provider Business Mailing Address
First Line	:	712 S TRUMBULL ST
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48708-4211
Country	:	US
Telephone Number	:	989-893-4351
Fax Number	:	989-893-6412

Provider Business Practice Location Address
First Line	:	712 S TRUMBULL ST
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48708-4211
Country	:	US
Telephone Number	:	989-893-4351
Fax Number	:	989-893-6412

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/02/2005
Last Update Date	:	10/20/2014

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