Individual
DR. KEVIN M. HERZOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
601 JOHN ST, KALAMAZOO, MI 49007-5341
(269) 341-7654
Mailing address
5700 SOUTHWYCK BLVD, TOLEDO, OH 43614-1509
(800) 288-8325
(419) 866-5453
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
4301073426
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
220026538
RAILROAD
—
01
—
220027375
RAILROAD
—
05
—
4143745
—
MI
05
—
4148320
—
MI
01
—
4301073426
MEDICAL LICENSE
MI
Enumeration date
11/23/2005
Last updated
09/29/2021
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