Provider Demographics
NPI:1710095112
Name:ERMAN, HOWARD MARK (PHD)
Entity Type:Individual
Prefix:
First Name:HOWARD
Middle Name:MARK
Last Name:ERMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 MAYNARD ST
Mailing Address - Street 2:SUITE 808
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48104-2437
Mailing Address - Country:US
Mailing Address - Phone:734-663-2485
Mailing Address - Fax:734-663-2485
Practice Address - Street 1:400 MAYNARD ST
Practice Address - Street 2:SUITE 808
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48104-2437
Practice Address - Country:US
Practice Address - Phone:734-663-2485
Practice Address - Fax:734-663-2485
Is Sole Proprietor?:No
Enumeration Date:2006-08-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301002927103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
11275741OtherCAQH
11275741OtherCAQH
ON28350Medicare ID - Type Unspecified