Individual
DR. SANDRA HERZWURM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
411 TOWN PARK BLVD, EVANS, GA 30809-3089
(706) 854-2500
(706) 854-2559
Mailing address
P.O BOX 1758, EVANS, GA 30809-3089
(706) 854-2500
(706) 854-2500
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
031945
GA
208000000X
Pediatrics Physician
Primary
031945
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000685506D
—
GA
Enumeration date
06/13/2005
Last updated
02/07/2024
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