Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 036777 | GA |
NPI | 1053318774 |
---|---|
Provider Name | Dr. Howard Kenneth Herman |
First Address | Fayetteville, GA 30214-4565 |
Second Address | Stockbridge, GA 30281-7366 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2005 |
Last Update Date | 09/02/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000544387B | (05) | GA |
000544387C | (05) | GA |
000544387K | (05) | GA |
0379519 | CIGNA (01) | GA |
40010665 | RAILROAD MEDICARE (01) | GA |
474095 | AETNA (01) | GA |
52414201 | BCBS OF GEORGIA (01) | GA |