Individual
DR. JOHN A HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9000 W WISCONSIN AVE, PEDIATRIC PALLIATIVE CARE, MILWAUKEE, WI 53226-4874
(414) 266-6469
(414) 266-1761
Mailing address
9000 W WISCONSIN AVE, PEDIATRIC PALLIATIVE CARE, MILWAUKEE, WI 53226-4874
(414) 266-6469
(414) 266-1761
Taxonomy
Speciality
Code
Description
License number
State
2080H0002X
Pediatric Hospice and Palliative Medicine Physician
Primary
22403
WI
208M00000X
Hospitalist Physician
22403
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008906261C
HUMANA
—
05
—
1386695112
—
WI
Enumeration date
05/15/2006
Last updated
01/25/2013
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