Healthcare Provider Details

I. General information

NPI: 1255806360
Provider Name (Legal Business Name): SHEM O JUMA MD, RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2018
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

326 NICHOLS RD
FITCHBURG MA
01420-1914
US

IV. Provider business mailing address

4215 S 30TH ST APT F138
TACOMA WA
98409-3238
US

V. Phone/Fax

Practice location:
  • Phone: 978-343-5271
  • Fax:
Mailing address:
  • Phone: 972-859-0146
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH60864581
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number3021343
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: