Provider Demographics
NPI:1679522957
Name:PALAT, HERMAN W (DO)
Entity type:Individual
Prefix:
First Name:HERMAN
Middle Name:W
Last Name:PALAT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:P. O. BOX 8500-6335
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-0001
Mailing Address - Country:US
Mailing Address - Phone:215-807-8000
Mailing Address - Fax:215-807-8235
Practice Address - Street 1:2451 GRANT AVE
Practice Address - Street 2:SUITE 1B
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-1004
Practice Address - Country:US
Practice Address - Phone:215-671-8900
Practice Address - Fax:215-671-1272
Is Sole Proprietor?:No
Enumeration Date:2006-05-06
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS002817L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102999OtherPERSONAL CHOICE
PA080104544OtherRAILROAD MEDICARE
PA102999OtherHIGHMARK BLUE SHIELD
PA0006566900007Medicaid
PA1026493OtherKEYSTONE MERCY
PA1230775OtherCIGNA
PA1591636OtherFIRST HEALTH
PA1820868OtherPHCS
PA00656690-02OtherAMERICHOICE
PA0058030000OtherIBC,KEYSTONE
PA0006566900004Medicaid
PA0006566900005Medicaid
PA10236OtherHEALTH PARTNERS
PA1481905OtherUNITED HEALTHCARE
PA2995OtherCLEAR CARE
PA19903OtherAETNA
PAPA0050878OtherTRICARE
PA1820868OtherPHCS
PA0006566900004Medicaid