Individual
TEDDY MATTHEW MUMU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1350 NE 122ND AVE, PORTLAND, OR 97230-2011
(503) 408-7010
Mailing address
1350 NE 122ND AVE, PORTLAND, OR 97230-2011
(503) 408-7010
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A187408
CA
207R00000X
Internal Medicine Physician
MD.MD.61479346
WA
207R00000X
Internal Medicine Physician
Primary
MD220083
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/16/2020
Last updated
07/08/2024
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