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General NPI Number Information
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NPI Number | 1801876164
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Entity Type | Individual
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Provider Name | EUGENE KERRY HERMAN MD
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Gender | Male
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Dates
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Enumeration Date | 01/20/2006
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Last Update Date | 12/27/2011
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Provider Practice Location Address
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Address Line | 29355 NORTHWESTERN HWY SUITE 210
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City | SOUTHFIELD
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State | MI
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Zip | 48034-1053
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Country | US
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Telephone | 248-223-9650
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Fax | 248-223-9662
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Provider Business Mailing Address
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Address Line | 29355 NORTHWESTERN HWY SUITE 210
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City | SOUTHFIELD
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State | MI
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Zip | 48034-1053
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Country | US
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Telephone | 248-223-9650
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Fax | 248-223-9662
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | EH049218
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License Number State | MI
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