Provider Demographics
NPI:1336138965
Name:HERZIG, BARBARA REGINA (MD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:REGINA
Last Name:HERZIG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:BARBARA
Other - Middle Name:HERZIG
Other - Last Name:BELKIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1137 HOLLAND ST
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-6849
Mailing Address - Country:US
Mailing Address - Phone:248-644-3605
Mailing Address - Fax:
Practice Address - Street 1:1137 HOLLAND ST
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:MI
Practice Address - Zip Code:48009-6849
Practice Address - Country:US
Practice Address - Phone:248-644-3605
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI43010705502084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
H33054Medicare UPIN