Individual
MS. MOLLIE H HERZBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1400 NORTHSIDE FORSYTH DR STE 240, CUMMING, GA 30041-6017
(770) 844-0877
(770) 844-0891
Mailing address
1400 NORTHSIDE FORSYTH DR STE 240, CUMMING, GA 30041-6017
(770) 844-0877
(770) 844-0891
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
004448
GA
363AM0700X
Medical Physician Assistant
004448
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10044976
AMERIGROUP
GA
01
—
11051
BLUE CROSS BLUE SHIELD
GA
05
—
119046432
—
GA
05
—
119046432B
—
GA
05
—
119046432C
—
GA
01
—
333508
WELLCARE
GA
Enumeration date
05/17/2006
Last updated
07/07/2025
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