Provider Demographics
NPI:1477821320
Name:MARC HERTZMAN, M.D., P.C.
Entity Type:Organization
Organization Name:MARC HERTZMAN, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:HERTZMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-984-8800
Mailing Address - Street 1:11404 OLD GEORGETOWN RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-2865
Mailing Address - Country:US
Mailing Address - Phone:301-984-8800
Mailing Address - Fax:301-984-8802
Practice Address - Street 1:11404 OLD GEORGETOWN RD
Practice Address - Street 2:SUITE 203
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-2865
Practice Address - Country:US
Practice Address - Phone:301-984-8800
Practice Address - Fax:301-984-8802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-07
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDOO161152084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty