Provider Demographics
NPI:1134195308
Name:HUMPERT, EDWARD L (MD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:L
Last Name:HUMPERT
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 1:232 EAGLETON ESTATE BLVD
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-8416
Mailing Address - Country:US
Mailing Address - Phone:205-305-8437
Mailing Address - Fax:
Practice Address - Street 1:232 EAGLETON ESTATE BLVD
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33418-8416
Practice Address - Country:US
Practice Address - Phone:205-305-8437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-27
Last Update Date:2024-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000040582207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services