Provider Demographics
NPI:1134139595
Name:HERR, MARC WILLIAM (MD)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:WILLIAM
Last Name:HERR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:624 QUAKER LN STE 208C
Mailing Address - Street 2:
Mailing Address - City:HIGH POINT
Mailing Address - State:NC
Mailing Address - Zip Code:27262-3832
Mailing Address - Country:US
Mailing Address - Phone:336-781-4050
Mailing Address - Fax:336-781-4051
Practice Address - Street 1:624 QUAKER LN STE 208C
Practice Address - Street 2:
Practice Address - City:HIGH POINT
Practice Address - State:NC
Practice Address - Zip Code:27262-3832
Practice Address - Country:US
Practice Address - Phone:336-781-4050
Practice Address - Fax:336-781-4051
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60909611207Y00000X, 207YX0007X
NC2024-02028207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1134139595Medicaid
WA2120946Medicaid