MEDICARE: G. PATRICIA HERRERA MD PA

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	207R00000X	Internal Medicine Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2278935A	OTHER	NC	MEDICARE GROUP #

General Provider Information

NPI Number	:	1760676647
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	G. PATRICIA HERRERA MD PA

Provider Business Mailing Address
First Line	:	2501 ATRIUM DR
Second Line	:	SUITE 310
City	:	RALEIGH
State	:	NC
Zip	:	27607-6452
Country	:	US
Telephone Number	:	919-783-8334
Fax Number	:	919-783-8160

Provider Business Practice Location Address
First Line	:	2501 ATRIUM DR
Second Line	:	SUITE 310
City	:	RALEIGH
State	:	NC
Zip	:	27607-6452
Country	:	US
Telephone Number	:	919-783-8334
Fax Number	:	919-783-8160

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	ALMA RODRIGUEZ
Credential	:
Telephone Number	:	919-783-8334

Provider Enumeration Date	:	09/04/2007
Last Update Date	:	09/04/2007

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