=====================================================
General NPI Number Information
=====================================================
NPI Number | 1972592301
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DAVID A. HUMPHREY M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/18/2005
-----------------------------------------------------
Last Update Date | 03/27/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1 HOSPITAL DR STE 4100
-----------------------------------------------------
City | ASHEVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28801-4550
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-213-4600
-----------------------------------------------------
Fax | 828-213-4611
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 15268
-----------------------------------------------------
City | ASHEVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28813-0268
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 828-250-2833
-----------------------------------------------------
Fax | 828-665-8275
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number | 9500949
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------