Individual
VIJAY THUMMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 SE HOSPITAL AVE, STUART, FL 34994-2346
(772) 223-5618
(772) 288-5834
Mailing address
PO BOX 417, STUART, FL 34995-0417
(772) 223-2832
(772) 781-2716
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
21468
MS
207R00000X
Internal Medicine Physician
90851
SC
207R00000X
Internal Medicine Physician
MD.203826
LA
208M00000X
Hospitalist Physician
MD.203826
LA
208M00000X
Hospitalist Physician
Primary
ME135589
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1001058
—
LA
05
—
100996900
—
FL
01
—
YVWSW
FLORIDA BLUE
FL
Enumeration date
08/06/2007
Last updated
11/27/2024
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