DAVID R. HERTZOG


Address: 2412 W Passyunk Ave, Philadelphia, PA 19145-4114
Phone: 2154622100

DAVID R. HERTZOG (NPI# 1336188945) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1336188945
Entity Type Individual
Full Name DAVID R. HERTZOG
Credential MD
Practice Address 2412 W Passyunk Ave
Philadelphia
PA 19145-4114
Mailing Address 40 Valley Stream Pkwy
Suite 100
Malvern
PA 19355-1407
Practice Telephone 2154622100
Practice Fax Number 2154623100
Mailing Telephone 6106448900
Mailing Fax Number 6106448909
Enumeration Date 2006-06-06
Last Update Date 2020-05-28
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2085R0204X Radiology
Specialization: Vascular & Interventional Radiology
MD027999E PA Allopathic & Osteopathic Physicians
N 208600000X Surgery MD027999E PA Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
NJ AMERIHEALTH 0045155000 01
NJ CIGNA 0506464005 01
NJ 3435709 05
MO 1336188945 05
NJ OXFORD MES131 01
NJ AETNA 36952 01

Provider Secondary Practice Location

Address Telephone Number Fax Number
201 Dunn Rd, Florissant, MO 630317928 3148303841 3148310153
2235 Staples Mill Rd Ste 104, Richmond, VA 232302942 8043559729
25 Crossroads Dr Ste 110, Owings Mills, MD 211175444 4103632192

Other Providers DAVID HERTZOG

NPI Name Taxonomy Address Enumeration
1427036441 David E Hertzog Anesthesiology 4485 William Flynn Hwy, Suite 3, Allison Park, PA 15101-1424 2006-01-09

Office Location

Street Address 2412 W PASSYUNK AVE
City PHILADELPHIA
State PA
Zip Code 19145-4114

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1518564350 Bj's Wholesale Club Inc. Eyewear Supplier (Equipment, not the service) 2300a Rear W Oregon Ave, Philadelphia, PA 19145 2020-10-05
1376069559 Kyle James Hughes Physical Therapist 2192 W Oregon Ave Fl 3, Philadelphia, PA 19145 2017-08-18
1821519752 John A Takacs Dmd Clinic/Center 1707w Passyunk Ave, Philadelphia, PA 19145 2017-06-30
1033573209 Kenneth Donahue Dentist 1517 Packer Avenue, Philadelphia, PA 19145 2016-04-13
1437516895 Kimberly Wyand Physical Therapist 2129 Oregon St, Philadelphia, PA 19145 2016-01-15
1760856538 Liji Vipin Nurse Practitioner 1615 Oregon Ave, Philadelphia, PA 19145 2015-11-17
1528333846 Gina Marie Doyle Registered Nurse 1930 S. Broad Street, Philadelphia, PA 19145 2012-03-20
1639446214 Thao T Tran Pharmacist 2014-24 South Broad St, Philadelphia, PA 19145 2011-11-25
1649573171 Phyllis Yang Internal Medicine 1700 S Broad St, Unit 201, Philadelphia, PA 19145 2010-12-05
1326364613 South Philadelphia Open Mri, LLC Clinic/Center 1834 West Oregon Avenue, Philadelphia, PA 19145 2010-04-13
Find all providers in zip 19145

Taxonomy Information

Taxonomy Code 2085R0204X
Grouping Allopathic & Osteopathic Physicians
Classification Radiology
Specialization Vascular & Interventional Radiology

Taxonomy Definition

A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1184854531 John Yoon Radiology 9 N 9th St Unit 510, Philadelphia, PA 19107-3154 2009-07-20
1144423096 Jonathan Ira Lieberman Radiology 1016 Chestnut St, Thomas Jefferson University Hospital, Philadelphia, PA 19107-5010 2007-06-07
1760441760 James Frederick Mcguckin Jr. Radiology 2929 Arch Street, Suite 1705, Philadelphia, PA 19104-2866 2006-03-20
1588639819 American Access Care of Sp LLC Radiology 2412-14 West Passyunk Ave., Philadelphia, PA 19145-4114 2006-02-21
1104816453 Huynh Doan Radiology Broad & Vine St, Philadelphia, PA 19102 2005-10-27
1174513105 Mark Hysell Radiology Broad & Vine St S, Philadelphia, PA 19102 2005-10-21
1699774257 Image Guided Surgery Associates, PC Radiology 5735 Ridge Ave, Ste 106, Philadelphia, PA 19128-1745 2005-07-17
1033753405 Stc Pediatrics LLC Radiology 160 E Erie Ave, Philadelphia, PA 19134-1011 2019-10-29
1033670153 Jung Hyun Yun Radiology 5501 Old York Road, Philadelphia, PA 19141 2019-03-29
1720561186 Temple Faculty Practice Plan, Inc Radiology 3401 N Broad St, Philadelphia, PA 19140-5103 2018-09-12
Find all providers in PHILADELPHIA

Competitor

Search similar providers

City PHILADELPHIA
Zip Code 19145

Improve Information

Please comment or provide details below to improve the information on DAVID R. HERTZOG.

Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

Trending Searches