Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 0618000497 | VA |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 0618000497 | VA |
NPI | 1093750317 |
---|---|
Provider Name | Glenn Howard Hermann |
First Address | Collinsville, VA 24078-2240 |
Second Address | Collinsville, VA 24078-2240 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2006 |
Last Update Date | 04/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009231854 | (05) | VA |
040437 | BLUE CROSS BLUE SHIELD (01) | VA |
450168 | COBINED INSURANCE CO OF A (01) | VA |
541741479 | (05) | VA |
541741479 | ACCORDIA NATIONAL (01) | VA |
541741479 | AETNA (01) | VA |
541741479 | ALL ALLIANCE PPO (01) | VA |
541741479 | CARILION HEALTH PLANS (01) | VA |
541741479 | CIGNA HEALTHCARE (01) | VA |
541741479 | CONSECO HEALTH INSURANCE (01) | VA |
541741479 | GAATEWAY/PRIMARY PHYSICAN (01) | VA |
541741479 | MAIL HANDLERS BENEFIT (01) | VA |
541741479 | UNITED HEALTH CARE (01) | VA |
5674 | VISION WITH B/C B/S (01) | VA |
910899 | COLE (01) | VA |
9615238 | CIGNA HEALTHCARE (01) | VA |
U09453 | (02) | VA |