MEDICARE: DR. MICHAEL BRUCE HERR M.D.

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	207W00000X	Ophthalmology Physician	D035699	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346231495
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL BRUCE HERR M.D.

Provider Business Mailing Address
First Line	:	200 HOSPITAL DR
Second Line	:	SUITE 600
City	:	GLEN BURNIE
State	:	MD
Zip	:	21061-5884
Country	:	US
Telephone Number	:	410-761-6551
Fax Number	:	410-766-2904

Provider Business Practice Location Address
First Line	:	200 HOSPITAL DR
Second Line	:	SUITE 600
City	:	GLEN BURNIE
State	:	MD
Zip	:	21061-5884
Country	:	US
Telephone Number	:	410-761-6551
Fax Number	:	410-766-2904

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

Provider Enumeration Date	:	10/28/2005
Last Update Date	:	06/20/2018

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