Individual
DR. MARK DUMAIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
500 CHARLES ST, LA PLATA, MD 20646-5931
(301) 609-4857
(301) 609-4105
Mailing address
500 CHARLES ST, LA PLATA, MD 20646-5931
(301) 609-4857
(301) 609-4105
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
D0053813
MD
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
D0053813
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
135400100
—
MD
01
—
145724700
DEPARTMENT OF LABOR
—
01
—
5092523
AETNA PPO
—
01
—
6052423
AETNA HMO
—
01
—
60644802
BCBS MARYLAND
—
01
—
S3990056
BCBS DC
—
Enumeration date
09/21/2005
Last updated
06/04/2012
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