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NPI Code Detail

MEDICARE: DR. DONALD EDWARD HERTWECK MD

MEDICARE: DR. DONALD EDWARD HERTWECK MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician9801298NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1265432447
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DONALD EDWARD HERTWECK MD
Provider Business Mailing Address
First Line : 2500 SUMMIT AVE
Second Line :
City : GREENSBORO
State : NC
Zip : 27405-4522
Country : US
Telephone Number : 336-621-2500
Fax Number : 336-478-2541
Provider Business Practice Location Address
First Line : 2500 SUMMIT AVE
Second Line :
City : GREENSBORO
State : NC
Zip : 27405-4522
Country : US
Telephone Number : 336-621-2500
Fax Number : 336-478-2541
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2005
Last Update Date : 12/19/2012

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