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Individual
HERBERT R SQUIRES
Active
Individual
HERBERT R SQUIRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
12397
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123976
—
SC
01
—
582296052-562
BLUE CROSS
SC
Enumeration date
07/03/2006
Last updated
07/24/2013
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