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General NPI Number Information
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NPI Number | 1679511737
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Entity Type | Individual
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Provider Name | RICHARD A. HUMES M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/02/2006
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Last Update Date | 06/24/2021
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Provider Practice Location Address
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Address Line | 3901 BEAUBIEN BLVD - CHILDRENS HOSPITAL OF MICHIGAN 4TH FL
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City | DETROIT
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State | MI
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Zip | 48201
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Country | US
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Telephone | 313-745-5082
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Fax | 313-993-0894
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Provider Business Mailing Address
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Address Line | 4201 SAINT ANTOINE ST UHC 5D MAILBOX 226 UNIVERSITY PEDIATRICIANS
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City | DETROIT
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State | MI
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Zip | 48201-2153
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Country | US
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Telephone | 313-745-4405
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Fax | 313-966-0665
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number | 4301044429
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License Number State | MI
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