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Individual

JOHANN HERBERTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
109 BEE ST, CHARLESTON, SC 29401-5703
(843) 577-5011
Mailing address
109 BEE ST, CHARLESTON, SC 29401-5703
(843) 577-5011

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
39419
KY
207RN0300X
Nephrology Physician
Primary
39419
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
64105919
KY
Enumeration date
08/07/2006
Last updated
09/18/2015
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