Individual
DR. JOEL D HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
515 QUARTER ST, GLADWIN, MI 48624-1959
(989) 426-9286
Mailing address
2050 WILLOW BEACH ST, KEEGO HARBOR, MI 48320-1210
(248) 342-8025
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
050649
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
JH050649
BLUE SHIELD
MI
Enumeration date
06/29/2006
Last updated
07/08/2007
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