Provider Demographics
NPI:1417921115
Name:DUMOIS, RICHARD ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ANTHONY
Last Name:DUMOIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3885 OAKWATER CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32806-6257
Mailing Address - Country:US
Mailing Address - Phone:407-851-5600
Mailing Address - Fax:407-438-9585
Practice Address - Street 1:6735 CONROY RD
Practice Address - Street 2:STE 214
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32835-3565
Practice Address - Country:US
Practice Address - Phone:407-395-7040
Practice Address - Fax:407-395-7105
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2014-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME83235207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL2098790OtherUNITED HEALTHCARE
FL255603100Medicaid
FL03208OtherBC/BS
FL2619409OtherAETNA
FL03208OtherBC/BS
FLH04508Medicare UPIN
FL2098790OtherUNITED HEALTHCARE