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NPI Code Detail

MEDICARE: HERMAN L FERRELL M.D.

MEDICARE: HERMAN L FERRELL 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
1207R00000XInternal Medicine Physician036074327IL
2207P00000XEmergency Medicine PhysicianR7303MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1437153921
Entity Type Code : Individual
Provider Name (Legal Business Name) : HERMAN L FERRELL M.D.
Provider Business Mailing Address
First Line : 862 MINARCA DR
Second Line :
City : DES PERES
State : MO
Zip : 63131-2047
Country : US
Telephone Number : 618-482-7242
Fax Number :
Provider Business Practice Location Address
First Line : 129 N 8TH ST
Second Line :
City : EAST ST LOUIS
State : IL
Zip : 62201-2917
Country : US
Telephone Number : 618-482-7242
Fax Number : 314-810-1399
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2005
Last Update Date : 10/29/2009

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Directions to “ HERMAN L FERRELL M.D.” Practice Location

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