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General NPI Number Information
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NPI Number | 1871595041
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Entity Type | Individual
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Provider Name | STEPHEN M HUMBERT DO
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Gender | Male
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Dates
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Enumeration Date | 06/01/2005
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Last Update Date | 06/30/2022
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Provider Practice Location Address
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Address Line | 2510 W TOWNSHIP LINE RD
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City | HAVERTOWN
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State | PA
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Zip | 19083-5212
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Country | US
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Telephone | 484-450-4500
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Fax | 484-450-0575
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Provider Business Mailing Address
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Address Line | 2510 W TOWNSHIP LINE RD
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City | HAVERTOWN
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State | PA
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Zip | 19083-5212
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Country | US
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Telephone | 484-450-4500
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Fax | 484-450-0575
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | OS007256L
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License Number State | PA
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