Provider Demographics
NPI:1093727521
Name:HERNZ, WILLIAM JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:JOSEPH
Last Name:HERNZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:621 E HILLENDALE RD
Mailing Address - Street 2:
Mailing Address - City:CHADDS FORD
Mailing Address - State:PA
Mailing Address - Zip Code:19317-9364
Mailing Address - Country:US
Mailing Address - Phone:610-565-3587
Mailing Address - Fax:
Practice Address - Street 1:19 E SECOND ST
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-2918
Practice Address - Country:US
Practice Address - Phone:610-565-3587
Practice Address - Fax:610-566-1287
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD041292L2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAE54365Medicare UPIN
PA523335Medicare ID - Type Unspecified