Organization
SPECTRUM MEDICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK C HERMANN MD (PHYSICIAN)
(434) 793-4711
Entity
Organization
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
207LP2900X
Pain Medicine (Anesthesiology) Physician
0128376 1
VA
207RR0500X
Rheumatology Physician
0128376 1
VA
207X00000X
Orthopaedic Surgery Physician
Primary
0128376 1
VA
207XS0117X
Orthopaedic Surgery of the Spine Physician
0128376 1
VA
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
—
VA
2084N0400X
Neurology Physician
0128376 1
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
034487
ANTHEM BC OF VA
VA
05
—
8901398
—
NC
Enumeration date
09/13/2006
Last updated
06/10/2020
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