Individual
DR. MARK G HERTZBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
44150 12 MILE ROAD, SUITE 100, NOVI, MI 48377
(248) 347-5800
Mailing address
44150 12 MILE ROAD, SUITE 100, NOVI, MI 48377
(248) 347-5800
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301036759
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06314532
BCBS INDIVIDUAL
MI
01
—
1106314532
BLUE CROSS
MI
Enumeration date
12/06/2005
Last updated
09/19/2008
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