Healthcare Provider Details

I. General information

NPI: 1417148131
Provider Name (Legal Business Name): JOSEPH JAMES HERDMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2007
Last Update Date: 04/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1088 W BALTIMORE PIKE HCC II, SUITE 2407
MEDIA PA
19063-5146
US

IV. Provider business mailing address

PO BOX 350
SELLERSVILLE PA
18960-0350
US

V. Phone/Fax

Practice location:
  • Phone: 610-565-1808
  • Fax: 610-892-9535
Mailing address:
  • Phone: 215-723-2333
  • Fax: 215-723-9112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberC1-0008435
License Number StateDE
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMD440274
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: