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Individual

MIMI CUMBEST

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
15190 COMMUNITY RD, SUITE 230A, GULFPORT, MS 39503-3485
(228) 831-0204
(228) 831-1868
Mailing address
15190 COMMUNITY RD, SUITE 230A, GULFPORT, MS 39503-3485
(228) 831-0204
(228) 831-1868

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
13974
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00121635
MS
01
640727870
TAX ID
MS
Enumeration date
08/21/2006
Last updated
07/08/2007
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