Individual
DR. PETER A HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
216 S KINGSHIGHWAY BLVD, SAINT LOUIS, MO 63110-1026
(314) 362-5641
(314) 362-0369
Mailing address
300 GEORGE ST, FL 6, NEW HAVEN, CT 06511-6624
(203) 785-6610
(203) 785-6414
Taxonomy
Speciality
Code
Description
License number
State
207ZP0101X
Anatomic Pathology Physician
Primary
100219
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
023010176
—
MO
Enumeration date
07/18/2006
Last updated
11/29/2018
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