Individual
DR. EDWIN JACOB HUMPHREY IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
701 6TH ST S, ST PETERSBURG, FL 33701-4814
(727) 893-6182
(727) 893-6861
Mailing address
701 6TH ST S, ST PETERSBURG, FL 33701-4814
(727) 893-6182
(727) 893-6861
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
ME0051812
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
054869300
—
FL
Enumeration date
07/18/2006
Last updated
01/07/2022
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