Female

Stacey M. Humphreys M.D

Pediatric Critical Care Medicine Physician in Columbia, SC(View on Map)

Full Name

Stacey Michelle Humphreys M.D

NPI Number

1861698128

NPI Type

Individual Provider

Gender

Female

Enumeration Date

06/25/2007

Specialties

(Taxonomies)

Code

2080P0203X
208000000X

Primary Taxonomy

Yes
No

Licenses

State

South Carolina
West Virginia

License Number

37377
23402

Contact
Information

Purpose

Mailing
Location

Address

PO BOX 743904
9 RICHLAND MEDICAL PARK DR

City

Atlanta
Columbia

State

GA
SC

Postal Code

30374-3904
29203

Country

US
US

Telephone Number

(803) 296-7320
(803) 434-4603

Identifiers

Identifier

373777

Identifier State

SC

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 05/20/2019

Provider Address

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