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General NPI Number Information
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NPI Number | 1801071758
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Entity Type | Organization
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Legal Business Name | J. MICHAEL HERR DO LLC
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Dates
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Enumeration Date | 01/09/2008
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Last Update Date | 07/18/2013
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Provider Practice Location Address
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Address Line | 45 S MAIN ST SUITE 212
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City | WEST HARTFORD
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State | CT
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Zip | 06107-2402
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Country | US
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Telephone | 860-236-2515
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Fax |
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Provider Business Mailing Address
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Address Line | 39 WEBSTER HILL BLVD
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City | WEST HARTFORD
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State | CT
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Zip | 06107-3458
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Country | US
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Telephone | 860-561-1556
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Fax |
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Authorized Official
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Title or Position | DOCTOR
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Name | JAMES MICHAEL HERR
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Credential | DO
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Telephone | 860-561-1556
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 039908
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License Number State | CT
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