Individual
MARY M HIMMLER
Active
Individual
MARY M HIMMLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
4801
SD
225400000X
Rehabilitation Practitioner
M9054
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000010158222
BLUE SHIELD
ID
05
—
806820500
—
ID
01
—
B5634
BLUE CROSS
ID
Enumeration date
08/31/2006
Last updated
07/12/2024
Update your record
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