| Doctor Name: | GLENN HERMAN |
| NPI Number: | 1790727857 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 25MA04033300 |
| Business Practice Address: | 100 Bowman Dr Voorhees, NJ - 080439612 |
| Business Phone Number: | 8562473328 |
| Business Fax Number: | 8562473276 |
| Mailing Address: | 401 Route 73 N, 40 Lake Center Drive Suite 201a MARLTON |
| State: | NJ |
| Postal Code: | 080533425 |
| Phone Number: | 8563550340 |
| Fax Number: | 8563550346 |
| NPI Enumeration Date: | 06/12/2006 |
| NPI Last Update Date: | 03/29/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | 25MA04033300 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NJ |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |