Provider Demographics
NPI:1750511176
Name:DIAS, JEANNIE SCHUMPERT (DO)
Entity Type:Individual
Prefix:DR
First Name:JEANNIE
Middle Name:SCHUMPERT
Last Name:DIAS
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:2817 REILLY ST STOP A
Mailing Address - Street 2:WOMACK ARMY MEDICAL CENTER, MCXC DOM
Mailing Address - City:FORT BRAGG
Mailing Address - State:NC
Mailing Address - Zip Code:28310-7831
Mailing Address - Country:US
Mailing Address - Phone:910-907-8385
Mailing Address - Fax:910-907-7956
Practice Address - Street 1:2817 REILLY ST STOP A
Practice Address - Street 2:WOMACK ARMY MEDICAL CENTER, MCXC DOM
Practice Address - City:FORT BRAGG
Practice Address - State:NC
Practice Address - Zip Code:28310-7831
Practice Address - Country:US
Practice Address - Phone:910-907-8385
Practice Address - Fax:910-907-7956
Is Sole Proprietor?:No
Enumeration Date:2009-07-20
Last Update Date:2012-10-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SCSTUDENT207R00000X
VA0102202780207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine