NPIMap

Organization Active NPI

Mark Hertzberg MD PC

  • Internal Medicine Physician
  • Novi, MI
National Provider Identifier
1801042114
Registry record updated Sep 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
4301036759 Issued in MI
Legal business name
MARK HERTZBERG MD PC
Practice address
44150 Twelve Mile Road
Ste 100
Novi, MI 48377
Phone
(248) 357-3225
NPI assigned
Aug 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mark G Hertzberg, MD PC
Title
Owner
Phone
(248) 347-5800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 4301036759 MI Primary

Addresses

Primary practice location

44150 Twelve Mile Road
Ste 100
Novi, MI 48377

Mailing address

44150 12 Mile
Ste 100
Novi, MI 48377
Phone (248) 357-3225

Other identifiers 1

IdentifierTypeStateIssuer
1106314532OtherMIBLUE CROSS

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1219017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221868800000",
    "number": "1801042114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44150 12 MILE",
            "address_2": "STE 100",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "48377",
            "telephone_number": "248-357-3225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44150 TWELVE MILE ROAD",
            "address_2": "STE 100",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "48377",
            "telephone_number": "248-357-3225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK HERTZBERG MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-18",
        "last_updated": "2008-09-20",
        "status": "A",
        "authorized_official_last_name": "HERTZBERG",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-347-5800",
        "authorized_official_credential": "MD PC"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301036759",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "1106314532",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.