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Individual

DR. DEBORAH ANN HERRMANN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2305 S HIGHWAY 65 BLDG A, MARSHALL, MO 65340-3702
(660) 886-7800
(660) 831-3306
Mailing address
2305 S HIGHWAY 65 BLDG A, MARSHALL, MO 65340-3702
(660) 886-7800
(660) 831-3306

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
35894
IA
207Q00000X
Family Medicine Physician
Primary
36988
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0454215
IA
01
18134090
BCBS PROV #
MO
05
203230651
MO
01
36988
LICENSE
MO
01
38157
BLUE SHIELD OF IOWA
IA
01
P00192136
RAILROAD MEDICARE
IA
Enumeration date
06/22/2005
Last updated
12/05/2023
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