Individual
JOHN MOORE HUMPHREY
Active
Individual
JOHN MOORE HUMPHREY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
01077327A
IN
208000000X
Pediatrics Physician
01077327A
IN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
264910185
MEDICARE
IN
05
—
300014692
—
IN
Enumeration date
04/09/2009
Last updated
03/12/2025
Update your record
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