Individual
MARK HOERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1811 EDWINA DR, VIDALIA, GA 30474-8963
(912) 538-8105
(912) 538-8109
Mailing address
PO BOX 407, VIDALIA, GA 30475-0407
(912) 537-4986
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
070272
GA
207RP1001X
Pulmonary Disease Physician
Primary
070272
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003138585A
—
GA
01
—
2849327
AETNA
—
01
—
2K1057
HEALTHNET
—
01
—
71847
GHI HMO
—
01
—
P2017338
OXFORD
—
01
—
P55286567
MULTIPLAN
—
Enumeration date
07/08/2005
Last updated
10/17/2019
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