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Individual

ALLAN TILDEN HERMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
104 LEGION DR, LAS VEGAS, NM 87701-4804
(505) 426-3504
Mailing address
133 BENMORE DR STE 200, WINTER PARK, FL 32792-4111
(407) 646-7070

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD2022-0905
NM
207Q00000X
Family Medicine Physician
MD2022-0905
NM

Other

Enumeration date
05/09/2019
Last updated
05/13/2026
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