Provider Demographics
NPI:1184908493
Name:MUMAUGH, DAVID MICHAEL (RPH)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:MICHAEL
Last Name:MUMAUGH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8249 W BAKER AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80227-3131
Mailing Address - Country:US
Mailing Address - Phone:303-988-6537
Mailing Address - Fax:303-906-0386
Practice Address - Street 1:1235 E EVANS AVE
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-4531
Practice Address - Country:US
Practice Address - Phone:303-778-6069
Practice Address - Fax:303-698-2536
Is Sole Proprietor?:No
Enumeration Date:2011-10-05
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10782183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist