Basic Information
| Provider Information | |||||||||
| NPI: | 1013311067 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HERROLD | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | ALDEN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD, MPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 22 S GREENE ST RM S4D03 | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212011544 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103289878 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 22 S GREENE ST RM S4D03 | ||||||||
| Address2: | |||||||||
| City: | BALTIMORE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 212011544 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4103289878 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/20/2014 | ||||||||
| LastUpdateDate: | 06/22/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | A131063 | CA | N | Allopathic & Osteopathic Physicians | Surgery | 2086S0102X | D0087342 | MD | N | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care | 2086S0127X | D0087342 | MD | N | Allopathic & Osteopathic Physicians | Surgery | Trauma Surgery | 208600000X | D0087342 | MD | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.