Individual
RALEIGH GREEN HUMPHRIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
105 E 9TH ST, CORALVILLE, IA 52241-2209
(319) 467-2000
Mailing address
200 HAWKINS DR, IOWA CITY, IA 52242-1009
(319) 467-2000
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
32117
NC
208800000X
Urology Physician
Primary
MD-39882
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
44557
BLUE CROSS BLUE SHIELD
NC
05
—
8944557
—
NC
Enumeration date
09/22/2005
Last updated
12/14/2020
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