Individual
AUGUSTINE LAVELLE TUMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
730 W MARKET ST, LIMA, OH 45801-4602
(419) 226-4310
(419) 226-4315
Mailing address
3170 KETTERING BLVD, BLDG B 3RD FLOOR, MORAINE, OH 45439-4602
(937) 991-3188
(937) 223-9811
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35.074242
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000392256
BC/BS OF OHIO
OH
05
—
2068097
—
OH
01
—
POO86472
MEDICARE RR
OH
Enumeration date
06/04/2006
Last updated
10/23/2020
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