Provider Demographics
NPI:1134111701
Name:HERRMANN, DAVID S (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:S
Last Name:HERRMANN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 RANDOLPH ST
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27360-5123
Mailing Address - Country:US
Mailing Address - Phone:336-472-7343
Mailing Address - Fax:
Practice Address - Street 1:408 RANDOLPH ST
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:NC
Practice Address - Zip Code:27360-5123
Practice Address - Country:US
Practice Address - Phone:336-472-7343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-18
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1508111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCT10174Medicare UPIN
NC244498Medicare ID - Type Unspecified