Provider Demographics
NPI:1689666497
Name:HERMAN, JEFFREY S (MD)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:S
Last Name:HERMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:6950 FRANCE AVE S
Mailing Address - Street 2:MPLS RADIATION ONCOLOGY
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-2025
Mailing Address - Country:US
Mailing Address - Phone:952-920-4915
Mailing Address - Fax:952-915-6091
Practice Address - Street 1:550 OSBORNE RD NE
Practice Address - Street 2:UNITY RADIATION THERAPY CTR
Practice Address - City:FRIDLEY
Practice Address - State:MN
Practice Address - Zip Code:55432-2718
Practice Address - Country:US
Practice Address - Phone:763-784-1182
Practice Address - Fax:763-784-1637
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-17
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MN352032085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN2D631HEOtherBLUE CROSS/BLUE SHIELD
MNHP13510OtherHEALTH PARTNERS
MN2400004OtherMEDICA PRIMARY
WI32077400Medicaid
MN110584OtherCHOICE PLUS
MN25133OtherAMERICA'S PPO
MN104838OtherUCARE
MN2424221OtherMEDICA
MN963070250011OtherPREFERRED ONE
MN2400004OtherMEDICA PRIMARY