MEDICARE: NAISHAI R HERRIN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	D0074189	MD

General Provider Information

NPI Number	:	1164657177
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAISHAI R HERRIN MD

Provider Business Mailing Address
First Line	:	3523 OREGON OAK DR
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23234-4809
Country	:	US
Telephone Number	:	828-446-9308
Fax Number	:

Provider Business Practice Location Address
First Line	:	3523 OREGON OAK DR
Second Line	:
City	:	NORTH CHESTERFIELD
State	:	VA
Zip	:	23234-4809
Country	:	US
Telephone Number	:	828-446-9308
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/19/2009
Last Update Date	:	09/11/2013

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