Provider Demographics
NPI:1902867351
Name:HERMAN, ROBERT GEORGE (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:GEORGE
Last Name:HERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7670 MAPLE GRV
Mailing Address - Street 2:
Mailing Address - City:CHESTERLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44026-3449
Mailing Address - Country:US
Mailing Address - Phone:440-376-6089
Mailing Address - Fax:
Practice Address - Street 1:85 POHEGANUT DR
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:CT
Practice Address - Zip Code:06340-3252
Practice Address - Country:US
Practice Address - Phone:440-255-4455
Practice Address - Fax:440-255-4487
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2025-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT82823207QA0505X
OH35-050840207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH80507OtherQUALCHOICE
OH0660780Medicaid
OH341425870042OtherMEDICAL MUTUAL OF OHIO
OH264200000OtherDEPT OF LABOR
OH264200000OtherFEDERAL BLACK LUNG
OH000000339406OtherANTHEM
OH6600162OtherUNITED HEALTHCARE
OH6600162OtherUNITED HEALTHCARE
OH0660780Medicaid
OH4053908Medicare PIN
OHHE4053905Medicare ID - Type Unspecified
OH264200000OtherDEPT OF LABOR
OH264200000OtherFEDERAL BLACK LUNG
OH4053907Medicare PIN