Provider Demographics
NPI:1497745137
Name:HERMAN, GEORGE A (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:A
Last Name:HERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 359
Mailing Address - Street 2:
Mailing Address - City:WAPAKONETA
Mailing Address - State:OH
Mailing Address - Zip Code:45895-0359
Mailing Address - Country:US
Mailing Address - Phone:419-738-9601
Mailing Address - Fax:419-941-1368
Practice Address - Street 1:1007 W AUGLAIZE ST
Practice Address - Street 2:
Practice Address - City:WAPAKONETA
Practice Address - State:OH
Practice Address - Zip Code:45895-1351
Practice Address - Country:US
Practice Address - Phone:419-738-9601
Practice Address - Fax:419-941-1368
Is Sole Proprietor?:No
Enumeration Date:2005-10-25
Last Update Date:2009-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35053179207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0653556Medicaid
OH1497745137OtherNPI
OH080019718OtherMEDICARE RAILROAD
OH0653556Medicaid
OHA16813Medicare UPIN