Provider Demographics
NPI:1205867793
Name:MICHAEL, HERMAN J JR (MD)
Entity Type:Individual
Prefix:DR
First Name:HERMAN
Middle Name:J
Last Name:MICHAEL
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:860 SPRINGDALE DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341
Mailing Address - Country:US
Mailing Address - Phone:610-524-3703
Mailing Address - Fax:610-524-5990
Practice Address - Street 1:860 SPRINGDALE DR
Practice Address - Street 2:SUITE 100
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341
Practice Address - Country:US
Practice Address - Phone:610-524-3703
Practice Address - Fax:610-524-5990
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2012-09-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD034872E207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1282870Medicaid
PAE38675Medicare UPIN
PA1282870Medicaid