Individual
DAVID MUMFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9563 BORGATA BAY BLVD, LAS VEGAS, NV 89147-8014
(702) 818-5933
(702) 818-5934
Mailing address
7121 W CRAIG RD, #113 PMB 198, LAS VEGAS, NV 89129-6001
(702) 395-0405
(702) 395-0401
Taxonomy
Speciality
Code
Description
License number
State
173000000X
Legal Medicine
Primary
7359
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100510254
—
NV
01
—
7359
NV STATE BOARD MEDICAL
NV
01
—
NV1360
ANTHEM BCBS
NV
Enumeration date
08/24/2006
Last updated
07/09/2007
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