Provider Demographics
NPI:1841439163
Name:HUMPHREY, FREDERICK JAMES II (DO)
Entity type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:JAMES
Last Name:HUMPHREY
Suffix:II
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:9300 DEWITT LOOP
Mailing Address - Street 2:FORT BELVOIR COMMUNITY HOSPITAL
Mailing Address - City:FORT BELVOIR
Mailing Address - State:VA
Mailing Address - Zip Code:22060
Mailing Address - Country:US
Mailing Address - Phone:410-200-5256
Mailing Address - Fax:
Practice Address - Street 1:WALTER REED ARMY MEDICAL CENTER 6900 GEORGIA AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20307-0001
Practice Address - Country:US
Practice Address - Phone:202-782-3321
Practice Address - Fax:202-782-5007
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-10
Last Update Date:2011-08-18
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB048843002084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry