# DR. ANASTACIO G HERRERA JR.

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1487655213
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | 21312 | KY | Yes |

## Other

- **Enumeration date:** 08/02/2005
- **Last updated:** 06/07/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000049321 | ANTHEM PROVIDER NUMBER | KY |
| 01 | — | 611169409-00 | CHAMPUS PROVIDER NUMBER | KY |
| 05 | — | 64213127 | — | KY |
| 01 | — | TWCC611169409 | WORKMAN'S COMP PROVIDER \# | KY |