Doctor Name: | DR. BRYAN T KUMIGA |
NPI Number: | 1255622585 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.O. |
License Number: | 254654-1 |
Business Practice Address: | 171 Ashley Ave Charleston, SC - 294258908 |
Business Phone Number: | 8437921414 |
Business Fax Number: | |
Mailing Address: | Po Box 751461, CHARLOTTE |
State: | NC |
Postal Code: | 282751461 |
Phone Number: | 8437926200 |
Fax Number: | |
NPI Enumeration Date: | 04/20/2011 |
NPI Last Update Date: | 08/06/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 254654-1 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |