Individual
DR. MATTHEW RANDAL HUMPAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
501 1ST AVE, SOUTH SIOUX CITY, NE 68776-1703
(402) 494-3064
(712) 294-7299
Mailing address
621 S ILLINOIS AVE, SUITE 103, MASON CITY, IA 50401-5489
(641) 428-3041
(712) 264-3509
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD-42604
IA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47068731712
—
NE
Enumeration date
05/15/2012
Last updated
02/21/2020
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