Individual
DR. JOHN STEWART HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
2009 023 891
MO
208200000X
Plastic Surgery Physician
A99381
CA
208200000X
Plastic Surgery Physician
ME95230
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000633050
ANTHEM BLUE CROSS BLUE SHIELD
MO
01
—
1270930001
NORIDIAN/MEDICARE D-MERC
—
01
—
43-1817986
COMP RESULTS WORKERS COMP
—
05
—
507543601
—
MO
01
—
979387
HEALTHLINK
—
01
—
P00792431
RAILROAD MEDICARE
—
01
—
PENDING
GREAT WEST
—
Enumeration date
06/16/2006
Last updated
10/08/2010
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