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General NPI Number Information
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NPI Number | 1548503592
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Entity Type | Individual
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Provider Name | MS. JESSICA MAYUMI LUM
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Gender | Female
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Dates
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Enumeration Date | 03/28/2013
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Last Update Date | 05/28/2019
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Provider Practice Location Address
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Address Line | INFECTIOUS DISEASE G21 9500 EUCLID AVENUE
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City | CLEVELAND
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State | OH
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Zip | 44195-0001
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Country | US
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Telephone | 216-444-8845
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Fax | 216-445-9446
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Provider Business Mailing Address
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Address Line | INFECTIOUS DISEASE G21 9500 EUCLID AVENUE
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City | CLEVELAND
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State | OH
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Zip | 44195-0001
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Country | US
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Telephone | 216-444-8845
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Fax |
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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 | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | TL0006307
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 35.136151
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 125063477
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License Number State | IL
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