MEDICARE: DR. MICHAEL H HERBST D.P.M.

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	213E00000X	Podiatrist	00404	MD

General Provider Information

NPI Number	:	1902872245
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL H HERBST D.P.M.

Provider Business Mailing Address
First Line	:	3930 KNOWLES AVE
Second Line	:	SUITE 202
City	:	KENSINGTON
State	:	MD
Zip	:	20895-2428
Country	:	US
Telephone Number	:	301-942-8110
Fax Number	:	301-942-8530

Provider Business Practice Location Address
First Line	:	3930 KNOWLES AVE
Second Line	:	SUITE 202
City	:	KENSINGTON
State	:	MD
Zip	:	20895-2428
Country	:	US
Telephone Number	:	301-942-8110
Fax Number	:	301-942-8530

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

Provider Enumeration Date	:	02/27/2006
Last Update Date	:	05/11/2011

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