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NPI Code Detail

MEDICARE: DR. BARRY KEITH HERMAN M.D., M.M.M.

MEDICARE:  DR. BARRY KEITH HERMAN  M.D., M.M.M.
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
12084P0804XChild & Adolescent Psychiatry PhysicianG45054CA

General Provider Information

NPI Number : 1962747592
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BARRY KEITH HERMAN M.D., M.M.M.
Provider Business Mailing Address
First Line : 277 UPPER GULPH RD
Second Line :
City : RADNOR
State : PA
Zip : 19087-2417
Country : US
Telephone Number : 610-687-4354
Fax Number :
Provider Business Practice Location Address
First Line : 277 UPPER GULPH RD
Second Line :
City : RADNOR
State : PA
Zip : 19087-2417
Country : US
Telephone Number : 610-687-4354
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2012
Last Update Date : 12/08/2012

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