Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | MD15316 | RI |
Y | 111NI0900X | Internist | MD15316 | RI |
NPI | 1003253063 |
---|---|
Provider Name | Karl Herman |
First Address | Providence, RI 02906-2853 |
Second Address | Providence, RI 02906-2853 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2013 |
Last Update Date | 10/06/2016 |