Healthcare Provider Details

I. General information

NPI: 1457342347
Provider Name (Legal Business Name): MARIANNE HERR PAUL DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIANNE HERR-PAUL D. O.

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 12/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1408 BUCHANAN TRL W
GREENCASTLE PA
17225-8305
US

IV. Provider business mailing address

1408 BUCHANAN TRL W
GREENCASTLE PA
17225-8305
US

V. Phone/Fax

Practice location:
  • Phone: 717-597-2978
  • Fax: 717-597-3046
Mailing address:
  • Phone: 717-597-2978
  • Fax: 717-597-3046

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License NumberOS008131L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: