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NPI Code Detail

MEDICARE: GREGORY ERIC MUMM M.D.

MEDICARE: GREGORY ERIC MUMM M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician48817WI
2207RR0500XRheumatology Physician7481SD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1548228810
Entity Type Code : Individual
Provider Name (Legal Business Name) : GREGORY ERIC MUMM M.D.
Provider Business Mailing Address
First Line : PO BOX 86370
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57118-6370
Country : US
Telephone Number : 605-322-7510
Fax Number : 605-322-6475
Provider Business Practice Location Address
First Line : 6100 S LOUISE AVE STE 1130
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57108-6021
Country : US
Telephone Number : 605-504-1600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2006
Last Update Date : 10/31/2019

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Directions to “ GREGORY ERIC MUMM M.D.” Practice Location

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