Provider Demographics
NPI:1497808752
Name:HERRON, GARLAND E (MD)
Entity Type:Individual
Prefix:DR
First Name:GARLAND
Middle Name:E
Last Name:HERRON
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 1:607 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:ASBURY PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-5292
Mailing Address - Country:US
Mailing Address - Phone:732-774-0200
Mailing Address - Fax:732-774-1019
Practice Address - Street 1:607 8TH AVE
Practice Address - Street 2:
Practice Address - City:ASBURY PARK
Practice Address - State:NJ
Practice Address - Zip Code:07712-5292
Practice Address - Country:US
Practice Address - Phone:732-774-0200
Practice Address - Fax:732-774-1019
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07981300207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ154025UUGMedicare PIN