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NPI Code Detail

MEDICARE: MITCHELL S HUMPHREY DO

MEDICARE: MITCHELL S HUMPHREY DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianOS012331PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1538168315
Entity Type Code : Individual
Provider Name (Legal Business Name) : MITCHELL S HUMPHREY DO
Provider Business Mailing Address
First Line : 4950 BUFFALO RD
Second Line :
City : ERIE
State : PA
Zip : 16510-2304
Country : US
Telephone Number : 814-899-7000
Fax Number : 814-899-0334
Provider Business Practice Location Address
First Line : 4950 BUFFALO RD
Second Line :
City : ERIE
State : PA
Zip : 16510-2304
Country : US
Telephone Number : 814-899-7000
Fax Number : 814-899-0334
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2005
Last Update Date : 10/05/2020

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Directions to “ MITCHELL S HUMPHREY DO” Practice Location

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