Individual
GLENN HERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 BOWMAN DR, VOORHEES, NJ 08043-9612
(856) 247-3328
(856) 247-3276
Mailing address
401 ROUTE 73 N, 40 LAKE CENTER DRIVE SUITE 201A, MARLTON, NJ 08053-3425
(856) 355-0340
(856) 355-0346
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
25MA04033300
NJ
207VX0000X
Obstetrics Physician
Primary
25MA04033300
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0075851000
AMERIHEALTH #
NJ
01
—
221494442
TAX ID #
NJ
01
—
22280
AMERIGROUP #
NJ
01
—
271348772
TAX ID
NJ
01
—
2K9098
HEALTHNET #
NJ
01
—
3422508
AETNA HMO #
NJ
01
—
4234565
AETNA PPO #
NJ
01
—
60028477
HORIZON NJ HEALTH #
NJ
01
—
8219768
GHI PPO
NJ
01
—
P3226875
OXFORD #
NJ
Enumeration date
06/12/2006
Last updated
03/29/2012
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