Individual
DR. DAVID FUMO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5165 MCCARTY LN, LAFAYETTE, IN 47905-8764
(765) 448-8000
(765) 448-7619
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
01089444A
IN
208800000X
Urology Physician
35.139890
OH
208800000X
Urology Physician
4301502961
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300073235
—
IN
01
—
815500558
MEDICARE PTAN
IN
Enumeration date
04/23/2015
Last updated
11/03/2023
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