Provider Demographics
NPI:1437190261
Name:BUMP, GREGORY MATTHEW (MD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:MATTHEW
Last Name:BUMP
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 1:3459 5TH AVE
Mailing Address - Street 2:MUH 9 SOUTH
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-3236
Mailing Address - Country:US
Mailing Address - Phone:412-692-4888
Mailing Address - Fax:412-647-4050
Practice Address - Street 1:3459 FIFTH AVE
Practice Address - Street 2:MVH 9-SOUTH
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213
Practice Address - Country:US
Practice Address - Phone:412-692-4888
Practice Address - Fax:412-692-4825
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2021-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD428684207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I14827Medicare UPIN
PA109237Medicare PIN