Provider Demographics
NPI:1801189022
Name:DUMAS, MARCUS JAMES
Entity Type:Individual
Prefix:MR
First Name:MARCUS
Middle Name:JAMES
Last Name:DUMAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1228 MAPLE WALK CIR
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30032-2278
Mailing Address - Country:US
Mailing Address - Phone:404-289-1917
Mailing Address - Fax:404-289-1145
Practice Address - Street 1:1228 MAPLE WALK CIR
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30032-2278
Practice Address - Country:US
Practice Address - Phone:404-289-1917
Practice Address - Fax:404-289-1145
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-20
Last Update Date:2011-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACN0028842242376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide