Healthcare Provider Details

I. General information

NPI: 1194721803
Provider Name (Legal Business Name): WILLIAM HARRY HARTZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2005
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

H-42 OMEGA DRIVE
NEWARK DE
19713
US

IV. Provider business mailing address

101 GREENWOOD AVE SUITE 150
JENKINTOWN PA
19046-2627
US

V. Phone/Fax

Practice location:
  • Phone: 302-738-1700
  • Fax: 302-738-0100
Mailing address:
  • Phone: 215-379-8458
  • Fax: 267-620-1638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number35.132810
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD022230E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: