Healthcare Provider Details

I. General information

NPI: 1750311973
Provider Name (Legal Business Name): JAMES G. HERMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 11/26/2022
Certification Date: 11/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 E MICHIGAN AVE
LANSING MI
48912-1811
US

IV. Provider business mailing address

6411 PINE HOLLOW DR
EAST LANSING MI
48823-9737
US

V. Phone/Fax

Practice location:
  • Phone: 269-567-9835
  • Fax: 269-567-9841
Mailing address:
  • Phone: 269-567-9835
  • Fax: 269-567-9841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number4301046476
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: