Provider Demographics
NPI:1588614366
Name:AFTAB, HUMA S (MD)
Entity Type:Individual
Prefix:
First Name:HUMA
Middle Name:S
Last Name:AFTAB
Suffix:
Gender:M
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:PO BOX 2583
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29602-2583
Mailing Address - Country:US
Mailing Address - Phone:864-232-2734
Mailing Address - Fax:864-232-8126
Practice Address - Street 1:505 N MAIN ST STE C
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-2019
Practice Address - Country:US
Practice Address - Phone:864-232-2734
Practice Address - Fax:864-232-8126
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2018-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC25921207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC259213Medicaid
SCAA06705740Medicare PIN
SC259213Medicaid
SCI98000Medicare UPIN