Provider Demographics
NPI:1336942259
Name:MUWUMBA, PAUL
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:
Last Name:MUWUMBA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 BEDFORD RD APT 8D
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-3972
Mailing Address - Country:US
Mailing Address - Phone:857-207-6097
Mailing Address - Fax:
Practice Address - Street 1:178 LOWELL ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MA
Practice Address - Zip Code:02420-2719
Practice Address - Country:US
Practice Address - Phone:781-778-3600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-27
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN1001931164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse