Provider Demographics
NPI:1285788042
Name:MUMA, RICHARD DEAN (PA-C, PHD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:DEAN
Last Name:MUMA
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Gender:M
Credentials:PA-C, PHD
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Mailing Address - Street 1:1845 FAIRMOUNT ST
Mailing Address - Street 2:WICHITA STATE UNIVERSITY
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67260-0043
Mailing Address - Country:US
Mailing Address - Phone:316-978-3060
Mailing Address - Fax:316-978-3072
Practice Address - Street 1:1845 FAIRMOUNT ST
Practice Address - Street 2:WICHITA STATE UNIVERSITY
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67260-0043
Practice Address - Country:US
Practice Address - Phone:316-978-3060
Practice Address - Fax:316-978-3072
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2009-11-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS15-00430363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant