MEDICARE: MICHAEL HERTZ M.D.

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	207V00000X	Obstetrics & Gynecology Physician	037973	MI

General Provider Information

NPI Number	:	1972673192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL HERTZ M.D.

Provider Business Mailing Address
First Line	:	35000 FORD RD
Second Line	:	SUITE 3
City	:	WESTLAND
State	:	MI
Zip	:	48185-3719
Country	:	US
Telephone Number	:	734-721-4700
Fax Number	:	734-721-9186

Provider Business Practice Location Address
First Line	:	35000 FORD RD
Second Line	:	SUITE 3
City	:	WESTLAND
State	:	MI
Zip	:	48185-3719
Country	:	US
Telephone Number	:	734-721-4700
Fax Number	:	734-721-9186

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

Provider Enumeration Date	:	11/08/2006
Last Update Date	:	05/06/2008

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