Provider Demographics
NPI:1780493924
Name:MPUMURO, JOSEPH
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:MPUMURO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:JOE
Other - Middle Name:
Other - Last Name:MPUMURO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:JOE
Mailing Address - Street 1:17316 E WAGON TRAIL PKWY
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80015-1833
Mailing Address - Country:US
Mailing Address - Phone:303-875-7597
Mailing Address - Fax:
Practice Address - Street 1:17316 E WAGON TRAIL PKWY
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80015-1833
Practice Address - Country:US
Practice Address - Phone:303-875-7597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-02
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
172A00000X, 347E00000X
CO347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes347C00000XTransportation ServicesPrivate Vehicle
No172A00000XOther Service ProvidersDriverGroup - Single Specialty
No347E00000XTransportation ServicesTransportation Broker