Individual
DR. MARK C HERMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
109 BRIDGE ST STE 300, DANVILLE, VA 24541-1222
(434) 793-4711
(434) 797-2514
Mailing address
109 BRIDGE ST STE 300, DANVILLE, VA 24541-1222
(434) 793-4711
(434) 797-2514
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
0101045002
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006440371
—
VA
01
—
034487
ANTHEM BC OF VA GROUP#
VA
01
—
098983
ANTHEM BC OF VIRGINIA
VA
01
—
200000404
INDIVIDUAL MEDICARE NO
VA
01
—
200010326
RR MEDICARE
VA
01
—
890583P
NC MEDICAID NO
NC
Enumeration date
03/21/2006
Last updated
06/10/2020
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