MEDICARE: HERMAN GIST 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	207RC0000X	Cardiovascular Disease Physician	MD20174	DC
2	207RI0011X	Interventional Cardiology Physician	MD20174	DC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275528234
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HERMAN GIST M.D.

Provider Business Mailing Address
First Line	:	11140 ROCKVILLE PIKE
Second Line	:	SUITE 100, #335
City	:	ROCKVILLE
State	:	MD
Zip	:	20852-3106
Country	:	US
Telephone Number	:	202-557-4046
Fax Number	:	202-882-1274

Provider Business Practice Location Address
First Line	:	106 IRVING ST NW
Second Line	:	SUITE 1500 NORTH TOWER
City	:	WASHINGTON
State	:	DC
Zip	:	20010-2927
Country	:	US
Telephone Number	:	202-829-2834
Fax Number	:	202-882-1274

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

Provider Enumeration Date	:	09/15/2005
Last Update Date	:	03/02/2011

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Directions to “ HERMAN GIST M.D.” Practice Location

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