Provider Demographics
NPI:1396858858
Name:HERMAN, JAMES RICHARD (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:RICHARD
Last Name:HERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1701 DEVONSHIRE DR
Mailing Address - Street 2:SUITE #101
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29204
Mailing Address - Country:US
Mailing Address - Phone:803-254-2800
Mailing Address - Fax:803-254-2890
Practice Address - Street 1:1701 DEVONSHIRE DR
Practice Address - Street 2:SUITE #101
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204
Practice Address - Country:US
Practice Address - Phone:803-254-2800
Practice Address - Fax:803-254-2890
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC12540207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q242404108Medicare ID - Type Unspecified
C61172Medicare UPIN