MEDICARE: NEIL HERTZBERG DPM

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
1	213ES0103X	Foot & Ankle Surgery Podiatrist	5901000838	MI

General Provider Information

NPI Number	:	1902932924
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NEIL HERTZBERG DPM

Provider Business Mailing Address
First Line	:	6689 ORCHARD LAKE RD STE 275
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48322-3404
Country	:	US
Telephone Number	:	248-569-9920
Fax Number	:	248-788-0455

Provider Business Practice Location Address
First Line	:	5028 VILLAGE SQUARE CIRCLE
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48322
Country	:	US
Telephone Number	:	248-569-9920
Fax Number	:	248-788-0455

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/26/2007
Last Update Date	:	05/25/2021

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Directions to “ NEIL HERTZBERG DPM” Practice Location

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