Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | ||
N | 175L00000X | Homeopath |
NPI | 1427516137 |
---|---|
Provider Name | Dr. Timothy Carmel Hertzberg |
First Address | Brighton, MI 48116-1522 |
Second Address | Brighton, MI 48116-1522 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/03/2019 |
Last Update Date | 11/06/2019 |