Healthcare Provider Details

I. General information

NPI: 1992786578
Provider Name (Legal Business Name): RICHARD EVAN WERMAN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2005
Last Update Date: 01/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4011 ROUTE 9 S
RIO GRANDE NJ
08242-1916
US

IV. Provider business mailing address

PO BOX 697
CAPE MAY COURT HOUSE NJ
08210-0697
US

V. Phone/Fax

Practice location:
  • Phone: 609-886-0477
  • Fax: 609-886-0529
Mailing address:
  • Phone: 609-463-2755
  • Fax: 609-463-2757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number0008389
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: