Provider Demographics
NPI:1457342347
Name:HERR PAUL, MARIANNE (DO)
Entity Type:Individual
Prefix:DR
First Name:MARIANNE
Middle Name:
Last Name:HERR PAUL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:MARIANNE
Other - Middle Name:
Other - Last Name:HERR-PAUL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:D O
Mailing Address - Street 1:1408 BUCHANAN TRL W
Mailing Address - Street 2:
Mailing Address - City:GREENCASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:17225-8305
Mailing Address - Country:US
Mailing Address - Phone:717-597-2978
Mailing Address - Fax:717-597-3046
Practice Address - Street 1:1408 BUCHANAN TRL W
Practice Address - Street 2:
Practice Address - City:GREENCASTLE
Practice Address - State:PA
Practice Address - Zip Code:17225-8305
Practice Address - Country:US
Practice Address - Phone:717-597-2978
Practice Address - Fax:717-597-3046
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS008131L204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA741825WPKMedicare PIN
PAF12825Medicare UPIN