Provider Demographics
NPI:1962747592
Name:HERMAN, BARRY KEITH (MD, MMM)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:KEITH
Last Name:HERMAN
Suffix:
Gender:M
Credentials:MD, MMM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:277 UPPER GULPH RD
Mailing Address - Street 2:
Mailing Address - City:RADNOR
Mailing Address - State:PA
Mailing Address - Zip Code:19087-2417
Mailing Address - Country:US
Mailing Address - Phone:610-687-4354
Mailing Address - Fax:
Practice Address - Street 1:277 UPPER GULPH RD
Practice Address - Street 2:
Practice Address - City:RADNOR
Practice Address - State:PA
Practice Address - Zip Code:19087-2417
Practice Address - Country:US
Practice Address - Phone:610-687-4354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-08
Last Update Date:2012-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG450542084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry