Individual
WILSON DUMORNAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
68723
GA
207YS0123X
Facial Plastic Surgery Physician
Primary
ME96799
FL
261QA1903X
Ambulatory Surgical Clinic/Center
68723
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
68723
GEORGIA MEDICAL LICENSE
GA
01
—
ME 96799
FLORIDA MEDICAL LICENSE
FL
Enumeration date
10/10/2006
Last updated
03/07/2023
Update your record
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