Provider Demographics
NPI:1205986395
Name:DUMAS, BRANDY E (PA)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:E
Last Name:DUMAS
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:3620 JOSEPH SIEWICK DR
Mailing Address - Street 2:SUITE 406
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033-1756
Mailing Address - Country:US
Mailing Address - Phone:703-359-8640
Mailing Address - Fax:703-591-6105
Practice Address - Street 1:3620 JOSEPH SIEWICK DR
Practice Address - Street 2:SUITE 406
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-1756
Practice Address - Country:US
Practice Address - Phone:703-359-8640
Practice Address - Fax:703-591-6105
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2010-12-03
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Provider Licenses
StateLicense IDTaxonomies
MA1908363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP00383635Medicare PIN
MAP91355Medicare UPIN
MAAP2353Medicare PIN