MEDICARE: DR. HEATHER HERMAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	D0048107	MD

General Provider Information

NPI Number	:	1073599924
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HEATHER HERMAN M.D.

Provider Business Mailing Address
First Line	:	2003 MEDICAL PKWY
Second Line	:	SUITE 370
City	:	ANNAPOLIS
State	:	MD
Zip	:	21401-7992
Country	:	US
Telephone Number	:	410-571-9700
Fax Number	:	410-571-9710

Provider Business Practice Location Address
First Line	:	2003 MEDICAL PKWY
Second Line	:	SUITE 370
City	:	ANNAPOLIS
State	:	MD
Zip	:	21401-7992
Country	:	US
Telephone Number	:	410-571-9700
Fax Number	:	410-571-9710

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/21/2005
Last Update Date	:	07/08/2007

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