Provider Demographics
NPI:1578323846
Name:DUMAIS, MAEVE BRYANE
Entity Type:Individual
Prefix:
First Name:MAEVE
Middle Name:BRYANE
Last Name:DUMAIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2464 BAYHILL DR
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32940-6340
Mailing Address - Country:US
Mailing Address - Phone:571-438-7173
Mailing Address - Fax:
Practice Address - Street 1:2464 BAYHILL DR
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32940-6340
Practice Address - Country:US
Practice Address - Phone:571-438-7173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant