Individual
MARY A HERZOG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
300 LAFAYETTE AVE SE # 3400, GRAND RAPIDS, MI 49503-4600
(616) 752-6615
Mailing address
300 LAFAYETTE AVE SE # 3400, GRAND RAPIDS, MI 49503-4600
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
4301093037
MI
Other
Enumeration date
07/01/2008
Last updated
07/01/2008
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