Humphries, Stefan G

Humphries, Stefan G is an individual health care provider with primary practice located at 301 Memorial Medical Pkwy , Daytona Beach FL 32117-5167. He recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as his primary health care specialty. Humphries, Stefan G can be contacted via phone (386) 231-6000.

Contact Information

Primary practice address
301 Memorial Medical Pkwy Daytona Beach FL 32117-5167
Phone: (386) 231-6000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 14305 Nevada
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 37261 Colorado
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 26359 Arizona
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X ME148755 Florida

Profile Details

NPI number 1346249315
LBN Legal business name Humphries, Stefan G
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2005
Last updated Mar 24th, 2021 - about 3 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346249315 NPPES
Other 10384750 CAQH
MEDICAID 22137246 CAQH
MEDICAID 1346249315 CAQH

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