Provider Demographics
NPI:1467494377
Name:HERRING, STEVEN J (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:J
Last Name:HERRING
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 1:1450 E BOOT RD
Mailing Address - Street 2:SUITE 600B
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-5300
Mailing Address - Country:US
Mailing Address - Phone:610-692-6787
Mailing Address - Fax:610-692-5706
Practice Address - Street 1:1450 E BOOT RD
Practice Address - Street 2:SUITE 600B
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-5300
Practice Address - Country:US
Practice Address - Phone:610-692-6787
Practice Address - Fax:610-692-5706
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD036155E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAE57977Medicare UPIN
531485Medicare ID - Type Unspecified