Provider Demographics
NPI:1649537846
Name:HERMAN, IRWIN A
Entity type:Individual
Prefix:DR
First Name:IRWIN
Middle Name:A
Last Name:HERMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7372 TIMBERROSE WAY
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95747-8302
Mailing Address - Country:US
Mailing Address - Phone:916-771-5272
Mailing Address - Fax:
Practice Address - Street 1:7372 TIMBERROSE WAY
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95747-8302
Practice Address - Country:US
Practice Address - Phone:916-771-5272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-12
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACFE 21487207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology