Organization
MARK HERTZBERG MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK G HERTZBERG MD PC (OWNER)
(248) 347-5800
Entity
Organization
Contact information
Practice address
44150 TWELVE MILE ROAD, STE 100, NOVI, MI 48377
(248) 357-3225
Mailing address
44150 12 MILE, STE 100, NOVI, MI 48377
(248) 357-3225
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
4301036759
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1106314532
BLUE CROSS
MI
Enumeration date
08/18/2008
Last updated
09/20/2008
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