Provider Demographics
NPI:1538193339
Name:HERSCHELMAN, MARC AARON (DO)
Entity type:Individual
Prefix:DR
First Name:MARC
Middle Name:AARON
Last Name:HERSCHELMAN
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:3100 BLUE RIDGE RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-8036
Mailing Address - Country:US
Mailing Address - Phone:919-781-7500
Mailing Address - Fax:919-881-9586
Practice Address - Street 1:3100 BLUE RIDGE RD
Practice Address - Street 2:SUITE 300
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-8036
Practice Address - Country:US
Practice Address - Phone:919-781-7500
Practice Address - Fax:919-881-9586
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2012-08-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC2007-01714207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2401625Medicare PIN