Individual
RALEIGH GREEN HUMPHRIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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
Update your record
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