Provider Demographics
NPI:1538192687
Name:HERMANN, CECELIA CAMBLIN (MD)
Entity type:Individual
Prefix:
First Name:CECELIA
Middle Name:CAMBLIN
Last Name:HERMANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CECELIA
Other - Middle Name:MARIE
Other - Last Name:HERMANN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:400 E COMMERCE ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:36037-2312
Mailing Address - Country:US
Mailing Address - Phone:334-382-1522
Mailing Address - Fax:334-382-1562
Practice Address - Street 1:400 E COMMERCE ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:AL
Practice Address - Zip Code:36037-2312
Practice Address - Country:US
Practice Address - Phone:334-382-1522
Practice Address - Fax:334-382-1562
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2019-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.4321207R00000X, 207Q00000X
FLME0031530207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-15629OtherBCBS OF ALABAMA
AL129107Medicaid
AL129107Medicaid
AL515-15629OtherBCBS OF ALABAMA