Individual
JOHN L HERTZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106-1716
(216) 844-3881
(216) 844-5883
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714
(216) 383-6616
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
35072227
OH
2084P0804X
Child & Adolescent Psychiatry Physician
35072227
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000224416
UNISON
OH
01
—
000000532997
ANTHEM
OH
05
—
0943457
—
OH
05
—
2203930
—
OH
01
—
363633
WELLCARE MEDICAID
OH
01
—
7032237
AETNA
OH
Enumeration date
03/18/2006
Last updated
01/14/2021
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