Healthcare Provider Details

I. General information

NPI: 1902867351
Provider Name (Legal Business Name): ROBERT GEORGE HERMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2006
Last Update Date: 08/31/2025
Certification Date: 08/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 POHEGANUT DR
GROTON CT
06340-3252
US

IV. Provider business mailing address

7670 MAPLE GRV
CHESTERLAND OH
44026-3449
US

V. Phone/Fax

Practice location:
  • Phone: 440-255-4455
  • Fax: 440-255-4487
Mailing address:
  • Phone: 440-376-6089
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number82823
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35-050840
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: