Provider Demographics
NPI:1689605990
Name:DUMAS, MARK A (DC)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:A
Last Name:DUMAS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:723 PHILLIPS AVE
Mailing Address - Street 2:BLDG C.
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43612-1300
Mailing Address - Country:US
Mailing Address - Phone:419-478-0303
Mailing Address - Fax:419-478-0430
Practice Address - Street 1:723 PHILLIPS AVE
Practice Address - Street 2:BLDG C.
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43612-1300
Practice Address - Country:US
Practice Address - Phone:419-478-0303
Practice Address - Fax:419-478-0430
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2012-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1223111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0655143Medicaid
OH350018432OtherMEDICARE RAILROAD
OH350018432OtherMEDICARE RAILROAD
OH0589442Medicare PIN