Ken Allen Humphrey MD

NPI 1043268352 - Emergency Medicine - 207P00000X

NPI Details
NPI 1043268352
Gender Male
Enumeration Date 05/05/2006
Last Updated 03/04/2010
Entity Type Individual
Active Over 10 years ago
Practice Location
15 CRANTON WAY #112
SUITE #112
LAKE WYLIE SC, 29710, US
Phone (803) 831-7916
Fax (803) 831-7916
Business Location
15 CRANTON WAY #112
SUITE #112
LAKE WYLIE SC, 29710, US
Phone (803) 831-7916
Fax (803) 831-7916
Toxanomy
Taxonomy Code 207P00000X
License State New Mexico
License Number MD2004-0215
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According to our database, Dr. Ken Allen Humphrey MD NPI is 1043268352, taxonomy code is 207P00000X and license number is MD2004-0215, license state is located at New Mexico. Ken Allen Humphrey MD physically located at 15 Cranton Way #112, Lake Wylie SC, 29710. NPI Number Ken Allen Humphrey MD has the Individual type.

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1043268352 NPI number is provided on an as is basis without warranty of any kind. 1043268352 is maintained by the National Plan & Provider Enumeration System. The contents of Ken Allen Humphrey MD are for informational purposes only.