Individual
DR. STEPHEN ROBERT BUMP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD16028
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024591
—
OR
01
—
110093488
RR MEDICARE
OR
01
—
840449001
BLUE CROSS
OR
01
—
9305053253021
EMPLOYER ID
OR
01
—
H1395 02
PACIFIC SOURCE
OR
Enumeration date
07/03/2006
Last updated
07/09/2007
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