Provider Demographics
NPI:1922328673
Name:DUMA, GREGORY (MD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:
Last Name:DUMA
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 1:118 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:41011-1481
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3300 PRINCETON RD
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011
Practice Address - Country:US
Practice Address - Phone:513-868-9999
Practice Address - Fax:513-868-8898
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-04
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY28974207VB0002X, 207VB0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VB0002XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObesity Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0177606Medicaid