Individual
DR. DAVID R. HERTZOG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2412 W PASSYUNK AVE, PHILADELPHIA, PA 19145-4114
(215) 462-2100
(215) 462-3100
Mailing address
PO BOX 416210, BOSTON, MA 02241-1407
(610) 644-8900
(484) 924-0053
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
MD027999E
PA
208600000X
Surgery Physician
MD027999E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0045155000
AMERIHEALTH
NJ
01
—
0506464005
CIGNA
NJ
05
—
3435709
—
NJ
01
—
36952
AETNA
NJ
01
—
MES131
OXFORD
NJ
Enumeration date
06/06/2006
Last updated
11/26/2025
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