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:
Health care specialties
| Specialty | Code | License # | 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 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1346249315 | NPPES |
| Other | 10384750 | CAQH | |
| MEDICAID | 22137246 | CAQH | |
| MEDICAID | 1346249315 | CAQH |
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