Provider Demographics
NPI:1144357468
Name:HERPEL, GERARD A (PD)
Entity type:Individual
Prefix:
First Name:GERARD
Middle Name:A
Last Name:HERPEL
Suffix:
Gender:M
Credentials:PD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24465 GARRETT HWY
Mailing Address - Street 2:PO BOX 267
Mailing Address - City:MC HENRY
Mailing Address - State:MD
Mailing Address - Zip Code:21541-1311
Mailing Address - Country:US
Mailing Address - Phone:301-387-5300
Mailing Address - Fax:301-387-4994
Practice Address - Street 1:24465 GARRETT HWY
Practice Address - Street 2:
Practice Address - City:MC HENRY
Practice Address - State:MD
Practice Address - Zip Code:21541-1311
Practice Address - Country:US
Practice Address - Phone:301-387-5300
Practice Address - Fax:301-387-4994
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD09809183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist