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Individual
JOHN EDWARD HUMISTON
Active
Individual
JOHN EDWARD HUMISTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01081516A
IN
207Q00000X
Family Medicine Physician
A83402
CA
207QA0401X
Addiction Medicine (Family Medicine) Physician
01081516A
IN
207QA0401X
Addiction Medicine (Family Medicine) Physician
A83402
CA
Other
Enumeration date
08/31/2010
Last updated
03/17/2021
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