Basic Information
Provider Information
NPI: 1134256597
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUMM
FirstName: STEPHEN
MiddleName: D.
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 12510 PROSPERITY DR
Address2: SUITE 200
City: SILVER SPRING
State: MD
PostalCode: 209041663
CountryCode: US
TelephoneNumber: 2404855200
FaxNumber:  
Practice Location
Address1: 10801 LOCKWOOD DR
Address2: SUITE 200
City: SILVER SPRING
State: MD
PostalCode: 209011556
CountryCode: US
TelephoneNumber: 3015932002
FaxNumber: 3015934781
Other Information
ProviderEnumerationDate: 02/27/2007
LastUpdateDate: 07/07/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XL-228282MAN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RG0100XD0077877MDY Allopathic & Osteopathic PhysiciansInternal MedicineGastroenterology

No ID Information.


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