Provider Demographics
NPI:1770272817
Name:HERRMANN, PETER CHRISTOPHER FREDERIC (MD)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:CHRISTOPHER FREDERIC
Last Name:HERRMANN
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 1:155 FIFTH ST. NE
Mailing Address - Street 2:SUMMA HEALTH/FAMILY MEDICINE RESIDENCY
Mailing Address - City:BARBERTON
Mailing Address - State:OH
Mailing Address - Zip Code:44203
Mailing Address - Country:US
Mailing Address - Phone:330-615-3205
Mailing Address - Fax:330-761-6469
Practice Address - Street 1:155 FIFTH ST. NE
Practice Address - Street 2:SUMMA HEALTH/FAMILY MEDICINE RESIDENCY
Practice Address - City:BARBERTON
Practice Address - State:OH
Practice Address - Zip Code:44203
Practice Address - Country:US
Practice Address - Phone:330-615-3205
Practice Address - Fax:330-761-6469
Is Sole Proprietor?:No
Enumeration Date:2023-05-04
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program