Healthcare Provider Details

I. General information

NPI: 1174742472
Provider Name (Legal Business Name): KARA HERTZFELD MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2007
Last Update Date: 11/03/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5805 MONCLOVA RD
MAUMEE OH
43537-1839
US

IV. Provider business mailing address

1 SEAGATE STE 800
TOLEDO OH
43604-1558
US

V. Phone/Fax

Practice location:
  • Phone: 419-824-1952
  • Fax: 419-824-0344
Mailing address:
  • Phone: 567-585-1992
  • Fax: 419-824-7359

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number4301097412
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number35095467
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: