Individual
MARK MICHAEL HERSCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
145 NE BROADWAY, MYRTLE CREEK, OR 97457-0117
(541) 863-3146
(541) 863-3226
Mailing address
PO BOX 789, 145 NE BROADWAY, MYRTLE CREEK, OR 97457-0117
(541) 863-3146
(541) 863-3226
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO14354
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
138784
—
OR
Enumeration date
09/27/2006
Last updated
08/10/2011
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