Basic Information
| Provider Information | |||||||||
| NPI: | 1164865895 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HERZBERG | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 12410 MILESTONE CENTER DR | ||||||||
| Address2: | SUITE 225 | ||||||||
| City: | GERMANTOWN | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208767101 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3019440039 | ||||||||
| FaxNumber: | 3019720484 | ||||||||
| Practice Location | |||||||||
| Address1: | 25500 POINT LOOKOUT RD | ||||||||
| Address2: | EMERGENCY DEPARTMENT | ||||||||
| City: | LEONARDTOWN | ||||||||
| State: | MD | ||||||||
| PostalCode: | 206502015 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3019440039 | ||||||||
| FaxNumber: | 3019720484 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/11/2013 | ||||||||
| LastUpdateDate: | 06/30/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | D81516 | MD | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.