Provider Demographics
NPI:1851316566
Name:HERTZMAN, ALEX (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEX
Middle Name:
Last Name:HERTZMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:7845 OAKWOOD RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:GLENBURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-4266
Mailing Address - Country:US
Mailing Address - Phone:410-760-1171
Mailing Address - Fax:410-766-5387
Practice Address - Street 1:7845 OAKWOOD RD
Practice Address - Street 2:SUITE 301
Practice Address - City:GLENBURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-4266
Practice Address - Country:US
Practice Address - Phone:410-760-1171
Practice Address - Fax:410-766-5387
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDDOO32138207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
41510901OtherMARYLAND BC BS
T281OtherDC BC BS
B69516Medicare UPIN
41510901OtherMARYLAND BC BS