Dr. Keith D Herzog
Pediatrician Pediatric Infectious Diseases
3601 A St
Philadelphia
, Pennsylvania 19134-1043
Dr. Keith D Herzog
Pediatrician Pediatric Infectious Diseases
3601 A St
Philadelphia
, Pennsylvania 19134-1043
(215) 427-5371
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About
Features
Specialties
- Pediatrician
- Pediatric Infectious Diseases
Languages spoken
- English
Location
First Address
- Dr. Keith D Herzog
- 3601 A St. 1-102
- Philadelphia, PA
- Zip : 19134-1095
- Fax : (215) 427-5371
- Phone : (215) 427-6827
Second Address
- Dr. Keith D Herzog
- 3601 A St
- Philadelphia, PA
- Zip : 19134-1043
- Fax : (215) 427-5371
- Phone : (215) 427-6827
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208000000X | Pediatrician | MD038603E | PA |
| N | 2080P0208X | Pediatric Infectious Diseases | MD038603E | PA |
National Provider Identifier
| NPI | 1609800184 |
|---|---|
| Provider Name | Dr. Keith D Herzog |
| First Address | Philadelphia, PA 19134-1095 |
| Second Address | Philadelphia, PA 19134-1043 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 10/07/2006 |
| Last Update Date | 26/03/2014 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 001243961-0008 | (05) | PA |
| E82321 | (02) | PA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.