Humphrey, Edwin Jacob

Humphrey, Edwin Jacob is an individual health care provider with primary practice located at 701 6Th St S , St Petersburg FL 33701-4814. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Humphrey, Edwin Jacob can be contacted via phone (727) 893-6182.

Contact Information

Primary practice address
701 6Th St S St Petersburg FL 33701-4814
Phone: (727) 893-6182
Fax: (727) 893-6861
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X ME0051812 Florida

Profile Details

NPI number 1295754547
LBN Legal business name Humphrey, Edwin Jacob
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2006
Last updated Jan 7th, 2022 - about 4 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 1295754547 NPPES
Florida MEDICAID 054869300

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