Individual
TRICIA DUDEK HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1483 TOBIAS GADSON BLVD STE 109, CHARLESTON, SC 29407-4795
(843) 556-8110
(843) 556-8112
Mailing address
1483 TOBIAS GADSON BLVD STE 109, CHARLESTON, SC 29407-4795
(843) 556-8110
(843) 556-8112
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
40152
SC
208000000X
Pediatrics Physician
P7427
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
401522
—
SC
Enumeration date
03/21/2011
Last updated
01/15/2023
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