Humphrey, Stephen Raymond
Humphrey, Stephen Raymond is an individual health care provider with primary practice located at 9000 W Wisconsin Ave Pediatric Dermatology, Milwaukee WI 53226-4874. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatric Dermatology, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Humphrey, Stephen Raymond can be contacted via phone (414) 266-1569.Contact Information
Primary practice address
9000 W Wisconsin Ave Pediatric Dermatology
Milwaukee WI 53226-4874
Phone: (414) 266-1569
Fax: (414) 266-3315
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Dermatology | 207NP0225X | 58250 | Wisconsin |
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 58250 | Wisconsin |
Profile Details
| NPI number | 1417246257 |
|---|---|
| LBN Legal business name | Humphrey, Stephen Raymond |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 1st, 2011 |
| Last updated | Mar 12th, 2024 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417246257 | NPPES |
| Wisconsin | MEDICAID | 1417246257 |
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