Provider Demographics
NPI:1588767180
Name:LERMAN, ROY MICHAEL (MD)
Entity type:Individual
Prefix:
First Name:ROY
Middle Name:MICHAEL
Last Name:LERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 S HENDERSON RD
Mailing Address - Street 2:SUITE 308C
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406
Mailing Address - Country:US
Mailing Address - Phone:610-337-3111
Mailing Address - Fax:610-337-3506
Practice Address - Street 1:700 S HENDERSON RD
Practice Address - Street 2:SUITE 308C
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406
Practice Address - Country:US
Practice Address - Phone:610-337-3111
Practice Address - Fax:610-337-3506
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD044357L208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000734369OtherBCBS PERSONAL CHOICE
PA1030074OtherKEYSTONE MERCY
PA3074576OtherCIGNA
PA0638218000OtherKEYSTONE HPE
PA0016708170001Medicaid
PA455144OtherAETNA
PA250005825Medicare ID - Type UnspecifiedRAILROAD
PA734369MFFMedicare ID - Type Unspecified
PA0016708170001Medicaid