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Organization

HERMAN L. REID III MD LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. MARIA E PENN-REID BA (OFFICE MANAGER)
(812) 306-6631
Entity
Organization

Contact information

Practice address
7839 S PROFESSIONAL DR, FORT BRANCH, IN 47648-8405
(812) 306-6631
(812) 867-6951
Mailing address
18920 ROSCOMMON RD, EVANSVILLE, IN 47725-6417
(812) 306-6631
(812) 867-6951

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
01056394A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200389450
IN
05
201228280
IN
05
XXXXX3397
IL
Enumeration date
10/21/2011
Last updated
03/02/2015
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