Provider Demographics
NPI:1487682894
Name:HERMAN, DENNICE H (MD)
Entity Type:Individual
Prefix:
First Name:DENNICE
Middle Name:H
Last Name:HERMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 PLAYERS RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-8840
Mailing Address - Country:US
Mailing Address - Phone:828-495-7125
Mailing Address - Fax:
Practice Address - Street 1:322 MULBERRY ST SW
Practice Address - Street 2:SUITE A
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-5702
Practice Address - Country:US
Practice Address - Phone:828-757-6400
Practice Address - Fax:828-757-6424
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2017-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC32727207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1056GOtherBCBS
NC891056GMedicaid
NCD05484Medicare UPIN
NCNC2316BMedicare PIN