MEDICARE: DR. GARY M CUMMINS 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	207Q00000X	Family Medicine Physician	5290	RI

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	:	1992701775
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARY M CUMMINS M.D.

Provider Business Mailing Address
First Line	:	40 WALNUT ST
Second Line	:
City	:	NEWPORT
State	:	RI
Zip	:	02840-1928
Country	:	US
Telephone Number	:	401-849-4128
Fax Number	:	401-736-4248

Provider Business Practice Location Address
First Line	:	211 PARK ST
Second Line	:
City	:	ATTLEBORO
State	:	MA
Zip	:	02703-0963
Country	:	US
Telephone Number	:	401-864-2741
Fax Number	:

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

Provider Enumeration Date	:	06/25/2005
Last Update Date	:	02/06/2012

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