Individual
STEPHEN RAYMOND HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9000 W WISCONSIN AVE, PEDIATRIC DERMATOLOGY, MILWAUKEE, WI 53226-4874
(414) 266-1569
(414) 266-3315
Mailing address
9000 W WISCONSIN AVE, PEDIATRIC DERMATOLOGY, MILWAUKEE, WI 53226-4874
(414) 266-1569
(414) 266-3315
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
58250
WI
207NP0225X
Pediatric Dermatology Physician
58250
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417246257
—
WI
Enumeration date
04/01/2011
Last updated
03/12/2024
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