JOHN MICHAEL HUMENIUK (NPI# 1639164528) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639164528 |
| Entity Type | Individual |
| Full Name | JOHN MICHAEL HUMENIUK |
| Credential | M.D., LLC |
| Practice Address |
21 Memorial Medical Dr Greenville SC 29605-4407 |
| Practice Telephone | 8642959085 |
| Practice Fax Number | 8642951075 |
| Mailing Telephone | 8642959085 |
| Mailing Fax Number | 8642951075 |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2013-12-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
10819 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 108190 | 05 |
| Street Address |
21 MEMORIAL MEDICAL DR |
| City | GREENVILLE |
| State | SC |
| Zip Code | 29605-4407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205306099 | Prisma Health University Medical Group | Family Medicine | 110 Osage Drive, Greenville, SC 29605 | 2018-12-05 |
| 1306325626 | Lauren Foster Fiscus | Occupational Therapist | 1900 Augusta Street, Suite 2500, Greenville, SC 29605 | 2018-08-08 |
| 1063914372 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 1720 Augusta St, Greenville, SC 29605 | 2018-03-02 |
| 1144748385 | Johanna Ruth Henry | Speech-Language Pathologist | 1900 Augusta St., Suite 2500, Greenville, SC 29605 | 2017-09-08 |
| 1477083483 | Alexis Dean Pedigo | Speech-Language Pathologist | 1900 Augusta St, Suite 2500, Greenville, SC 29605 | 2017-06-13 |
| 1134658420 | Trace Christopher Deighan | Obstetrics & Gynecology | 890 West Faris Road, Suite 470, Greenville, SC 29605 | 2017-06-08 |
| 1023569837 | Blessed With Goodness, LLC | In Home Supportive Care | 716 E. Fairfield Road, Unit 120 (mailbox # 14), Greenville, SC 29605 | 2016-10-17 |
| 1972050953 | Suha Umina | Pharmacist | 975 W. Faris Road, Greenville, SC 29605 | 2016-09-07 |
| 1124470976 | Meredith Laine Cavagrotti | Specialist/Technologist | 700 Grove Rd, Greenville, SC 29605 | 2016-07-05 |
| 1205286895 | Med-trans Corporation | Ambulance | 552 Perimeter Rd, Greenville, SC 29605 | 2016-06-15 |
| Find all providers in zip 29605 | ||||
| Taxonomy Code | 207NS0135X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Procedural Dermatology |
| Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). |
| Notes: Source: American Board of Dermatology, 2007, www.abderm.org [1/1/2008: definition added, source added, title changed] Additional Resources: Some ABMS board certified dermatologists have completed a one-year ACGME approved fellowship in Procedural Dermatology, which has been offered since 2003. At this time the ABD does not offer subspecialty certification in Procedural Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568749299 | Dallas Dermatology | Dermatology | 4724 Wellington St, Greenville, TX 75401-4944 | 2011-11-09 |
| 1508988742 | Jennifer Marie Defazio | Dermatology | 517 Moye Blvd Fl 3, Ecu Physicians Dermatology, Moye Medical #2, Greenville, NC 27834-2849 | 2007-04-06 |
| 1912950775 | Rogers Dermatology, Pa | Dermatology | 3b Cleveland Ct, Greenville, SC 29607-2414 | 2006-05-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467016600 | Marcus Hutchison | Dermatology | 688 Albright Rd Ste 101, Rock Hill, SC 29730-6290 | 2019-04-23 |
| 1841511623 | Susan Fellows Vanepps | Dermatology | 8590 San Marcello Dr, #101, Myrtle Beach, SC 29579-5281 | 2010-06-16 |
| 1992726269 | The Palmetto Skin and Laser Center LLC | Dermatology | 1563 Health Care Dr, Rock Hill, SC 29732-3858 | 2006-07-22 |
| 1114902269 | Timothy Gerrard Woodall | Dermatology | 1563 Healthcare Dr, Rock Hill, SC 29732 | 2005-12-13 |
| 1346330271 | Paul L Ross | Dermatology | 109 Bee St, Charleston, SC 29401-5703 | 2006-10-13 |
| 1528048139 | Edward George Butler II | Dermatology | 109 Bee St, Charleston, SC 29401-5703 | 2006-01-19 |
| 1730165465 | Richard Eric White | Dermatology | 1563 Healthcare Dr, Rock Hill, SC 29732-3858 | 2005-12-15 |
| City | GREENVILLE |
| Zip Code | 29605 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.