Individual
JEFFREY COLE MUMPOWER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CAA
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
67.000320
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
67.000230
OHIO MEDICAL BOARD
OH
Enumeration date
06/20/2018
Last updated
06/20/2018
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