Basic Information
| Provider Information | |||||||||
| NPI: | 1609817964 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BRUMLEY | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | WAYNE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 30 COLES ORCH | ||||||||
| Address2: | |||||||||
| City: | DUXBURY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 023324349 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6172463719 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1193 SEA ST | ||||||||
| Address2: | |||||||||
| City: | QUINCY | ||||||||
| State: | MA | ||||||||
| PostalCode: | 021693544 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6174718683 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 81864 | MA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.