Provider Demographics
NPI:1134677354
Name:DUMM, NATHAN J (PA-C)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:J
Last Name:DUMM
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:8540 QUADAY AVE NE
Mailing Address - Street 2:
Mailing Address - City:OTSEGO
Mailing Address - State:MN
Mailing Address - Zip Code:55330-6522
Mailing Address - Country:US
Mailing Address - Phone:763-441-0298
Mailing Address - Fax:763-441-0591
Practice Address - Street 1:8540 QUADAY AVE NE
Practice Address - Street 2:
Practice Address - City:OTSEGO
Practice Address - State:MN
Practice Address - Zip Code:55330-6522
Practice Address - Country:US
Practice Address - Phone:763-441-0298
Practice Address - Fax:763-441-0591
Is Sole Proprietor?:No
Enumeration Date:2016-09-16
Last Update Date:2018-10-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant