Individual
SIDNEY ALAN HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
5430 MACCORKLE AVE SE, CHARLESTON, WV 25304-2224
(304) 925-3627
(304) 925-1163
Mailing address
1869 SHAMBLIN RUN RD, GIVEN, WV 25245-8034
(304) 588-7900
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
306
WV
363AM0700X
Medical Physician Assistant
Primary
811
WV
Other
Enumeration date
03/09/2006
Last updated
06/02/2016
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