Provider Demographics
NPI:1366471989
Name:HERRMANN, EUGENE DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:DAVID
Last Name:HERRMANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 THORN HILL LN
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45042-3750
Mailing Address - Country:US
Mailing Address - Phone:513-423-1170
Mailing Address - Fax:513-423-3366
Practice Address - Street 1:1055 SUMMITT SQ
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45042-3464
Practice Address - Country:US
Practice Address - Phone:513-423-6589
Practice Address - Fax:513-423-3366
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35037553H207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHA75162Medicare UPIN