Provider Demographics
NPI:1447284708
Name:HERMAN, BENJAMIN S (MD)
Entity type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:S
Last Name:HERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:121 MEDICAL CENTER DRIVE
Mailing Address - Street 2:SUITE 3650
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-2653
Mailing Address - Country:US
Mailing Address - Phone:207-721-8770
Mailing Address - Fax:207-721-8785
Practice Address - Street 1:1356A WASHINGTON STREET
Practice Address - Street 2:
Practice Address - City:BATH
Practice Address - State:ME
Practice Address - Zip Code:04530
Practice Address - Country:US
Practice Address - Phone:207-442-7926
Practice Address - Fax:207-442-0028
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01086781A207R00000X, 208M00000X
OH35.143688207R00000X, 208M00000X
ME016800207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEH87677Medicare UPIN