Individual
DWIGHT J HERTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
222 N 7TH ST, BISMARCK, ND 58501-4436
(701) 323-6000
(701) 323-5709
Mailing address
PO BOX 5501, BISMARCK, ND 58506-5501
(701) 323-6000
(701) 323-5709
Taxonomy
Speciality
Code
Description
License number
State
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
5462
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16184
—
ND
Enumeration date
08/16/2006
Last updated
09/04/2007
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