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General NPI Number Information
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NPI Number | 1407850324
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Entity Type | Individual
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Provider Name | STEVEN WAYNE MUMBAUER M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/09/2005
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Last Update Date | 07/10/2014
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Provider Practice Location Address
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Address Line | 19 GREEN HILLS DRIVE
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City | VERONA
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State | VA
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Zip | 24482-2659
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Country | US
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Telephone | 540-949-0118
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Fax | 540-932-2059
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Provider Business Mailing Address
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Address Line | 19 GREEN HILLS DRIVE
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City | VERONA
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State | VA
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Zip | 24482
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Country | US
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Telephone | 540-949-0118
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Fax | 540-932-2059
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 0101057329
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License Number State | VA
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