Provider Demographics
NPI:1972611333
Name:BUMB, STEVEN WALTER (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:WALTER
Last Name:BUMB
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 1:433 W HIGH ST
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:OH
Mailing Address - Zip Code:43506-1690
Mailing Address - Country:US
Mailing Address - Phone:419-636-1131
Mailing Address - Fax:419-636-3100
Practice Address - Street 1:433 W HIGH ST
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:OH
Practice Address - Zip Code:43506-1690
Practice Address - Country:US
Practice Address - Phone:419-636-1131
Practice Address - Fax:419-636-3100
Is Sole Proprietor?:No
Enumeration Date:2006-08-27
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35066028207R00000X, 207R00000X
KY42219208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0136230Medicaid
KYPENDINGOtherUNICARE/HEALTHLINK
KYPENDINGMedicaid
KY00656OtherMEDICARE GROUP MURRAY MEDICAL ASSOCIATES
KYPENDINGOtherGREAT-WEST
KYPENDINGOtherANTHEM BLUE CROSS
KY0228OtherMEDICARE GROUP MURRAY CALLOWAY HOSPITAL
OHBR9123072OtherMEDICARE GROUP - MIDWEST COMMUNITY HEALTH ASSOCIATES
KYPENDINGOtherHUMANA/CHOICECARE
KYPENDINGOtherGREAT-WEST
KYPENDINGMedicaid