Provider Demographics
NPI:1760463913
Name:HERMAN, ROBERT ALAN (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:ALAN
Last Name:HERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1509 RITCHIE HIGHWAY
Mailing Address - Street 2:STE F
Mailing Address - City:ARNOLD
Mailing Address - State:MD
Mailing Address - Zip Code:21012
Mailing Address - Country:US
Mailing Address - Phone:410-757-2077
Mailing Address - Fax:410-757-5184
Practice Address - Street 1:1509 RITCHIE HIGHWAY
Practice Address - Street 2:STE F
Practice Address - City:ARNOLD
Practice Address - State:MD
Practice Address - Zip Code:21012
Practice Address - Country:US
Practice Address - Phone:410-757-2077
Practice Address - Fax:410-757-5184
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2010-07-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD00478842084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
A59869Medicare UPIN
MD222LB314Medicare ID - Type Unspecified