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Individual
OLIVER WYNN HERNDON
Active
Individual
OLIVER WYNN HERNDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD067328L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018286180003
—
PA
01
—
204657
HEALTH AMERICA
PA
01
—
210438
UPMC
PA
01
—
P00058817
PALMETTO RR MEDICARE
PA
Enumeration date
08/17/2006
Last updated
07/08/2007
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