Individual
DOUGLAS VON HERZEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
825 CHALKSTONE AVE, MEDICAL EDUCATION, PROVIDENCE, RI 02908-4728
(401) 456-2000
Mailing address
255 PROMENADE ST, APT. @236, PROVIDENCE, RI 02908-5746
(619) 433-2045
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
LP03193
RI
207R00000X
Internal Medicine Physician
Primary
MD15730
RI
Other
Enumeration date
07/14/2014
Last updated
11/30/2021
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