Healthcare Provider Details
I. General information
NPI: 1740264613
Provider Name (Legal Business Name): HERMAN L MAEUSER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/02/2005
Last Update Date: 09/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1100 WESCOTT DR STE G3
FLEMINGTON NJ
08822-4600
US
IV. Provider business mailing address
1100 WESCOTT DR STE G3
FLEMINGTON NJ
08822-4600
US
V. Phone/Fax
- Phone: 908-788-1710
- Fax:
- Phone: 908-788-1710
- Fax: 908-788-1716
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | MA53781 |
| License Number State | NJ |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2086S0129X |
| Taxonomy | Vascular Surgery Physician |
| License Number | 25MA05378100 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: