Hertzog, David R.

Hertzog, David R. is an sole proprietor health care provider with primary practice located at 2412 W Passyunk Ave , Philadelphia PA 19145-4114. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Hertzog, David R. can be contacted via phone (215) 462-2100.

Contact Information

Primary practice address
2412 W Passyunk Ave Philadelphia PA 19145-4114
Fax: (215) 462-3100
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X MD027999E Pennsylvania
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X MD027999E Pennsylvania

Profile Details

NPI number 1336188945
LBN Legal business name Hertzog, David R.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 6th, 2006
Last updated Apr 29th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1336188945 NPPES
Missouri MEDICAID 1336188945
Missouri Other 0045155000
Missouri Other 0506464005
Missouri MEDICAID 3435709
Missouri Other 36952
Missouri Other MES131

Popular Providers