Individual
DR. MARK EDWARD HUMPHREY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
56 US HIGHWAY 321 BYP N, WINNSBORO, SC 29180-7100
(803) 635-6343
(803) 635-6343
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
R1133
KY
207Q00000X
Family Medicine Physician
Primary
36168
SC
2083P0901X
Public Health & General Preventive Medicine Physician
36168
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
361682
—
SC
Enumeration date
10/17/2006
Last updated
07/15/2024
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