MEDICARE: DR. MARIANNE HERR PAUL DO

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	204D00000X	Neuromusculoskeletal Medicine & OMM Physician	OS008131L	PA

General Provider Information

NPI Number	:	1457342347
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARIANNE HERR PAUL DO

Provider Business Mailing Address
First Line	:	1408 BUCHANAN TRL W
Second Line	:
City	:	GREENCASTLE
State	:	PA
Zip	:	17225-8305
Country	:	US
Telephone Number	:	717-597-2978
Fax Number	:	717-597-3046

Provider Business Practice Location Address
First Line	:	1408 BUCHANAN TRL W
Second Line	:
City	:	GREENCASTLE
State	:	PA
Zip	:	17225-8305
Country	:	US
Telephone Number	:	717-597-2978
Fax Number	:	717-597-3046

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

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	12/16/2008

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