Provider Demographics
NPI:1275097214
Name:JUMA, MOHAMED A
Entity Type:Individual
Prefix:
First Name:MOHAMED
Middle Name:A
Last Name:JUMA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 S ZUNI ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80223-1707
Mailing Address - Country:US
Mailing Address - Phone:720-998-5143
Mailing Address - Fax:
Practice Address - Street 1:150 S ZUNI ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80223-1707
Practice Address - Country:US
Practice Address - Phone:720-998-5143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-23
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)