Provider Demographics
NPI:1619910759
Name:DUMIT, MAURICE (MPT)
Entity Type:Individual
Prefix:
First Name:MAURICE
Middle Name:
Last Name:DUMIT
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2060 N. HUMBOLDT AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MILWUAKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53212
Mailing Address - Country:US
Mailing Address - Phone:414-265-5606
Mailing Address - Fax:414-265-5649
Practice Address - Street 1:2060 N HUMBOLDT AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53212-3504
Practice Address - Country:US
Practice Address - Phone:414-265-5606
Practice Address - Fax:414-265-5649
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI62470242251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI6247-024OtherPHYSICAL THERAPY LICENSE