Provider Demographics
NPI:1194833921
Name:HERMELE, HERBERT (MD)
Entity Type:Individual
Prefix:
First Name:HERBERT
Middle Name:
Last Name:HERMELE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 BLACK ROCK TPKE
Mailing Address - Street 2:ORTHOPAEDIC SPECIALTY GROUP
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06825-5508
Mailing Address - Country:US
Mailing Address - Phone:203-337-2600
Mailing Address - Fax:203-337-2666
Practice Address - Street 1:305 BLACK ROCK TPKE
Practice Address - Street 2:ORTHOPAEDIC SPECIALTY GROUP
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06825-5508
Practice Address - Country:US
Practice Address - Phone:203-337-2600
Practice Address - Fax:203-337-2666
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT017779207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTZS305OtherOXFORD HEALTH PLANS
TINOtherPOMCO
TINOtherORTHONET
CT010017779CT01OtherANTHEM BC/BS
TINOtherNORTHEAST HEALTH DI RECT
CT000503OtherHEALTH NET
TINOtherUNITED HEALTHCARE
TINOtherGREAT WEST
TINOtherCORVEL
CT0085203OtherAETNA
TINOtherNATIONAL PROVIDER NETWORK
CT001177799Medicaid
TINOtherNECHA HMC /PPO
TINOtherFIRST HEALTH / CCN
CT517779OtherCONNECTICARE
TINOtherCIGNA
TINOtherPIONEER
CT299241 (2) (3)OtherEMPIRE BC/BS
CTZS305OtherOXFORD HEALTH PLANS
TINOtherFIRST HEALTH / CCN