Provider Demographics
NPI:1831403229
Name:HERMAN, CARA J (PA-C)
Entity type:Individual
Prefix:
First Name:CARA
Middle Name:J
Last Name:HERMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CARA
Other - Middle Name:J
Other - Last Name:ABBONDANDOLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1400 FOREST GLEN RD
Mailing Address - Street 2:STE 200
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-1459
Mailing Address - Country:US
Mailing Address - Phone:301-681-5700
Mailing Address - Fax:
Practice Address - Street 1:116 DEFENSE HWY STE 400
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7050
Practice Address - Country:US
Practice Address - Phone:410-897-9841
Practice Address - Fax:410-897-9852
Is Sole Proprietor?:No
Enumeration Date:2010-07-28
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0004250363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
S567Medicare PIN
MDS576Medicare PIN