Provider Demographics
NPI:1730290933
Name:HERMANN, DAVID FREDERICK (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:FREDERICK
Last Name:HERMANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:209 SAVANNAH ST W
Mailing Address - Street 2:SUITE A
Mailing Address - City:TOCCOA
Mailing Address - State:GA
Mailing Address - Zip Code:30577-2341
Mailing Address - Country:US
Mailing Address - Phone:706-282-0779
Mailing Address - Fax:706-886-6471
Practice Address - Street 1:209 SAVANNAH ST W
Practice Address - Street 2:SUITE A
Practice Address - City:TOCCOA
Practice Address - State:GA
Practice Address - Zip Code:30577-2341
Practice Address - Country:US
Practice Address - Phone:706-282-0779
Practice Address - Fax:706-886-6471
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA0039819207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A42536Medicare UPIN