Healthcare Provider Details

I. General information

NPI: 1831189919
Provider Name (Legal Business Name): MARIA C. HERRON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/28/2005
Last Update Date: 09/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4199 GATEWAY BLVD
NEWBURGH IN
47630-8940
US

IV. Provider business mailing address

PO BOX 637273
CINCINNATI OH
45263-7273
US

V. Phone/Fax

Practice location:
  • Phone: 812-842-4200
  • Fax: 812-602-3174
Mailing address:
  • Phone: 812-842-4200
  • Fax: 812-842-4227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number42534
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number01054546A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: