Provider Demographics
NPI:1780716886
Name:RUMPH, BERNARD JOSEPH (DC)
Entity type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:JOSEPH
Last Name:RUMPH
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 1:5732 WILLIAMS LAKE ROAD
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48329-3274
Mailing Address - Country:US
Mailing Address - Phone:248-673-1215
Mailing Address - Fax:248-673-7027
Practice Address - Street 1:5732 WILLIAMS LAKE ROAD
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48329-3274
Practice Address - Country:US
Practice Address - Phone:248-673-1215
Practice Address - Fax:248-673-7027
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009123111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2301009123OtherCOMMERCIAL
MI95 F3 2972 0OtherBCBSM