Individual
MARK H HERMANOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
36500 AURORA DR, SUMMIT, WI 53066-4899
(262) 434-5000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207RA0201X
Allergy & Immunology (Internal Medicine) Physician
Primary
40807
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32516900
—
WI
Enumeration date
01/09/2007
Last updated
04/30/2024
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