MEDICARE: HERBERT P. TRIER, 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	101YM0800X	Mental Health Counselor	39000082A	IN
2	103TC0700X	Clinical Psychologist	20010504	IN
3	1041C0700X	Clinical Social Worker	35000290A	IN
4	1041C0700X	Clinical Social Worker	34001252A	IN
5	1041C0700X	Clinical Social Worker	34005094A	IN
6	2084P0800X	Psychiatry Physician	1032404A	IN
7	2084P0800X	Psychiatry Physician	01030633A	IN
8	2084P0800X	Psychiatry Physician	01017784	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	176530	OTHER		MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1477722197
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HERBERT P. TRIER, M.D.

Provider Business Mailing Address
First Line	:	310 E DUPONT RD
Second Line	:	SUITE 2
City	:	FORT WAYNE
State	:	IN
Zip	:	46825-2048
Country	:	US
Telephone Number	:	260-490-8110
Fax Number	:	260-490-7707

Provider Business Practice Location Address
First Line	:	310 E DUPONT RD
Second Line	:	SUITE 2
City	:	FORT WAYNE
State	:	IN
Zip	:	46825-2048
Country	:	US
Telephone Number	:	260-490-8110
Fax Number	:	260-490-7707

Authorized Official
Title or Position	:	OWNER/PHYSICIAN
Name	:	DR. HERBERT P TRIER
Credential	:	M.D.
Telephone Number	:	260-490-8110

Provider Enumeration Date	:	02/27/2008
Last Update Date	:	12/22/2011

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