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Individual

LYLA BLAKE-GUMBS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
NMRTC NEW ENGLAND, 43 SMITH ROAD, NEWPORT, RI 02841-1002
(401) 841-2005
Mailing address
NMRTC NEW ENGLAND, 43 SMITH ROAD, NEWPORT, RI 02841-1002
(401) 841-2005

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
282058
MA
207Q00000X
Family Medicine Physician
Primary
35-084366
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000224354
UNISON
01
000000382819
ANTHEM
OH
01
000000530381
ANTHEM
OH
05
2472793
OH
01
363362
WELLCARE
01
7082178
AETNA
OH
01
737670
BUCKEYE
OH
01
P00333095
RAILROAD MEDICARE
OH
Enumeration date
07/14/2006
Last updated
01/12/2026
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