Individual
JOSHUA BUMGARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
7700 WASHINGTON VILLAGE DR STE 210, CENTERVILLE, OH 45459-4094
(937) 562-2291
(937) 562-2293
Mailing address
7700 WASHINGTON VILLAGE DR STE 210, CENTERVILLE, OH 45459-4094
(937) 562-2291
(937) 562-2293
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.004139
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000893560
ANTHEM
OH
05
—
0110900
—
OH
Enumeration date
09/19/2014
Last updated
11/23/2020
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