Herzog, Keith D

Herzog, Keith D is an individual health care provider with primary practice located at 3601 A St , Philadelphia PA 19134-1043. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Infectious Diseases. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Herzog, Keith D can be contacted via phone (215) 427-6827.

Contact Information

Primary practice address
3601 A St Philadelphia PA 19134-1043
Phone: (215) 427-6827
Fax: (215) 427-5371
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD038603E Pennsylvania
Allopathic & Osteopathic Physicians / Pediatric Infectious Diseases 2080P0208X MD038603E Pennsylvania

Profile Details

NPI number 1609800184
LBN Legal business name Herzog, Keith D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 10th, 2006
Last updated Mar 26th, 2014 - about 10 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609800184 NPPES
Pennsylvania MEDICAID 001243961-0008

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