Provider Demographics
NPI:1497706972
Name:LERNER, HERMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:HERMAN
Middle Name:
Last Name:LERNER
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 1:15 BALDWIN HILL RD
Mailing Address - Street 2:
Mailing Address - City:PHILLIPSTON
Mailing Address - State:MA
Mailing Address - Zip Code:01331-9783
Mailing Address - Country:US
Mailing Address - Phone:978-249-2975
Mailing Address - Fax:
Practice Address - Street 1:6562 LAKE RD
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:WI
Practice Address - Zip Code:53598-9764
Practice Address - Country:US
Practice Address - Phone:608-846-4826
Practice Address - Fax:608-846-5119
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI48845-0202083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MABL8137538OtherDEA#
MAIO-2882Medicare UPIN
MAA36457Medicare ID - Type Unspecified