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Individual

JOHN EDWARD HUMISTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
12265 HANCOCK ST STE 42, CARMEL, IN 46032-5892
(317) 606-8778
Mailing address
12265 HANCOCK ST STE 42, CARMEL, IN 46032-5892
(317) 606-8778

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01081516A
IN
207Q00000X
Family Medicine Physician
A83402
CA
207QA0401X
Addiction Medicine (Family Medicine) Physician
01081516A
IN
207QA0401X
Addiction Medicine (Family Medicine) Physician
A83402
CA

Other

Enumeration date
08/31/2010
Last updated
03/17/2021
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