Provider Demographics
NPI:1831189919
Name:HERRON, MARIA C (MD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:C
Last Name:HERRON
Suffix:
Gender:F
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:PO BOX 637273
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-7273
Mailing Address - Country:US
Mailing Address - Phone:812-842-4200
Mailing Address - Fax:812-842-4227
Practice Address - Street 1:4199 GATEWAY BLVD
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:IN
Practice Address - Zip Code:47630-8940
Practice Address - Country:US
Practice Address - Phone:812-842-4200
Practice Address - Fax:812-602-3174
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO42534207V00000X
IN01054546A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000603333OtherANTHEM
IN200934360Medicaid
CO79937772Medicaid
INP00657331OtherRAILROAD MEDICARE