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General NPI Number Information
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NPI Number | 1225145451
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Entity Type | Individual
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Provider Name | DAVID MUMFORD M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/24/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 9563 BORGATA BAY BLVD
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City | LAS VEGAS
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State | NV
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Zip | 89147-8014
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Country | US
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Telephone | 702-818-5933
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Fax | 702-818-5934
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Provider Business Mailing Address
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Address Line | 7121 W CRAIG RD #113 PMB 198
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City | LAS VEGAS
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State | NV
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Zip | 89129-6001
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Country | US
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Telephone | 702-395-0405
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Fax | 702-395-0401
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 173000000X
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Taxonomy Name | Legal Medicine
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License Number | 7359
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License Number State | NV
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