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General NPI Number Information
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NPI Number | 1821156175
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Entity Type | Organization
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Legal Business Name | PETER HERTZAK, M.D., PMC
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 985 ROBERT BLVD. SUITE 105
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City | SLIDELL
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State | LA
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Zip | 70458
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Country | US
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Telephone | 985-641-6300
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Fax | 985-646-1409
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Provider Business Mailing Address
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Address Line | 985 ROBERT BLVD. SUITE 105
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City | SLIDELL
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State | LA
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Zip | 70458
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Country | US
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Telephone | 985-641-6300
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Fax | 985-646-1409
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. KAREN R MOTES
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Credential |
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Telephone | 985-690-8349
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 05273R
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 05273R
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License Number State | LA
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