Provider Demographics
NPI:1639261191
Name:RUMLEY, RICHARD LEE (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:LEE
Last Name:RUMLEY
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 1:503 BOWMAN GRAY DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27834-7286
Mailing Address - Country:US
Mailing Address - Phone:252-830-2728
Mailing Address - Fax:252-752-8288
Practice Address - Street 1:503 BOWMAN GRAY DR
Practice Address - Street 2:SUITE A
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-7286
Practice Address - Country:US
Practice Address - Phone:252-830-2728
Practice Address - Fax:252-752-8288
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC23874207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8973997Medicaid
NC210081BMedicare ID - Type Unspecified
NCC86243Medicare UPIN
NC8973997Medicaid