Provider Demographics
NPI:1487709333
Name:HAMID, HUMERA (MD)
Entity type:Individual
Prefix:
First Name:HUMERA
Middle Name:
Last Name:HAMID
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-3554
Mailing Address - Country:US
Mailing Address - Phone:812-282-1888
Mailing Address - Fax:812-285-8393
Practice Address - Street 1:510 SPRING STREET
Practice Address - Street 2:
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-3554
Practice Address - Country:US
Practice Address - Phone:812-282-1888
Practice Address - Fax:812-285-8393
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN11011866A173000000X
IN01063275A2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000056294OtherANTHEM GROUP
000000612952OtherANTHEM PIN
IN160780OtherMEDICARE GROUP
50704000OtherMAGELLAN GROUP
KYCK2274OtherMEDICARE RR
KY2444451000OtherPASSPORT GROUP
INCG3623OtherMEDICARE RR
KY65927857OtherMEDICAID GROUP
IN100386460OtherMEDICAID GROUP
1063415297OtherNPI GROUP
KY2444451000OtherPASSPORT GROUP