MEDICARE: MARC R. HERDMAN 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	207P00000X	Emergency Medicine Physician	35-080792	OH

General Provider Information

NPI Number	:	1891773453
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARC R. HERDMAN M.D.

Provider Business Mailing Address
First Line	:	2323 W 5TH AVE STE 225
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43204-4899
Country	:	US
Telephone Number	:	614-224-6420
Fax Number	:	614-224-6423

Provider Business Practice Location Address
First Line	:	2323 W 5TH AVE STE 225
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43204-4899
Country	:	US
Telephone Number	:	614-224-6420
Fax Number	:	614-224-6423

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

Provider Enumeration Date	:	01/04/2006
Last Update Date	:	03/07/2022

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Directions to “ MARC R. HERDMAN M.D.” Practice Location

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