Provider Demographics
NPI:1548230493
Name:FERRERAS, HERMINIA DE GUZMAN (MD)
Entity Type:Individual
Prefix:DR
First Name:HERMINIA
Middle Name:DE GUZMAN
Last Name:FERRERAS
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 1:146 MEDICAL PARK RD STE 110
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-8529
Mailing Address - Country:US
Mailing Address - Phone:650-642-0533
Mailing Address - Fax:704-471-4101
Practice Address - Street 1:146 MEDICAL PARK RD STE 110
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-8529
Practice Address - Country:US
Practice Address - Phone:650-642-0533
Practice Address - Fax:704-471-4101
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200200352080P0008X, 2084N0402X
NC200200350207PE0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0005XAllopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric Medicine
No2080P0008XAllopathic & Osteopathic PhysiciansPediatricsNeurodevelopmental Disabilities
No2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D3848OtherMEDCOST
SCNC1491Medicaid
NC891357RMedicaid
NC1357ROtherBCBS OF NC
NC7837542OtherAETNA
3019645OtherCIGNA
D3848OtherMEDCOST