Dr. Mark Carl Herzberg
Periodontist
Va Medical Center One Veterans Drive
Minneapolis
, Minnesota 55417
Dr. Mark Carl Herzberg
Periodontist
Va Medical Center One Veterans Drive
Minneapolis
, Minnesota 55417
(612) 626-2651
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About
Features
Specialties
- Periodontist
Languages spoken
- English
Location
First Address
- Dr. Mark Carl Herzberg
- 3927 York Ave S
- Minneapolis, MN
- Zip : 55410-1164
- Fax : (612) 626-2651
- Phone : (612) 929-7540
Second Address
- Dr. Mark Carl Herzberg
- Va Medical Center One Veterans Drive
- Minneapolis, MN
- Zip : 55417
- Fax : (612) 626-2651
- Phone : (612) 467-4716
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0300X | Periodontist | 8687 | MN |
National Provider Identifier
| NPI | 1073731998 |
|---|---|
| Provider Name | Dr. Mark Carl Herzberg |
| First Address | Minneapolis, MN 55410-1164 |
| Second Address | Minneapolis, MN 55417 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 23/04/2007 |
| Last Update Date | 08/07/2007 |
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.