Provider Demographics
NPI:1427068774
Name:HERSMAN, ROBERT E (OD OPTOMETRIST)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:E
Last Name:HERSMAN
Suffix:
Gender:M
Credentials:OD OPTOMETRIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 9TH AVE N
Mailing Address - Street 2:
Mailing Address - City:HOPKINS
Mailing Address - State:MN
Mailing Address - Zip Code:55343-8087
Mailing Address - Country:US
Mailing Address - Phone:952-935-2020
Mailing Address - Fax:952-935-5660
Practice Address - Street 1:29 9TH AVE N
Practice Address - Street 2:
Practice Address - City:HOPKINS
Practice Address - State:MN
Practice Address - Zip Code:55343-8087
Practice Address - Country:US
Practice Address - Phone:952-935-2020
Practice Address - Fax:952-935-5660
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1606152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist