| William R Herzog Jr, MD | |
|
10710 Charter Dr, Suite 400, Columbia, MD 21044-2858 | |
| (410) 997-7979 | |
| (410) 997-9231 |
| Full Name | William R Herzog Jr |
|---|---|
| Gender | Male |
| Speciality | Cardiovascular Disease (cardiology) |
| Experience | 43 Years |
| Location | 10710 Charter Dr, Columbia, Maryland |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902873979 | NPI | - | NPPES |
| P00963606 | Other | MD | RAILROAD MEDICARE |
| 0061936 | Other | MD | AETNA |
| 523202-06 | Other | MD | CAREFIRST OF MARYLAND |
| V879-0001 | Other | MD | CAREFIRST GHMSI AND BLUE CHOICE |
| 543951500 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0011X | Internal Medicine - Interventional Cardiology | D41959 (Maryland) | Primary |
| 207RC0000X | Internal Medicine - Cardiovascular Disease | D41959 (Maryland) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Southeastern Regional Medical Center | Lumberton, NC | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Southeastern Regional Physician Services | 7012058548 | 33 |
| Entity Name | Southeastern Regional Physician Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427282045 PECOS PAC ID: 7012058548 Enrollment ID: O20100106000556 |
| Mailing Address | Practice Location Address |
|---|---|
| William R Herzog Jr, MD 10710 Charter Dr, Suite 400, Columbia, MD 21044-2858 Ph: (410) 997-7979 | William R Herzog Jr, MD 10710 Charter Dr, Suite 400, Columbia, MD 21044-2858 Ph: (410) 997-7979 |
Dr. Jon Kent Minford, M.D. Internal Medicine Medicare: Medicare Enrolled Practice Location: 10710 Charter Dr, Suite G020, Columbia, MD 21044 Phone: 410-964-2212 Fax: 410-964-0380 | |
Dr. Jacob Cherian, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 5450 Knoll North Dr, Columbia, MD 21045 Phone: 410-964-5311 Fax: 410-964-8578 | |
Dr. Tejaswi Rajasekhara Sastry, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 10710 Charter Dr, Suite G020, Columbia, MD 21044 Phone: 410-964-2212 Fax: 410-964-0380 | |
Michael Howard Kelemen, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 5450 Knoll North Dr, Suite 200b, Columbia, MD 21045 Phone: 410-964-5303 | |
Dr. Joseph F Gibbons, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 6250 Old Dobbin Ln, Columbia, MD 21045 Phone: 410-730-3399 Fax: 443-478-4737 | |
Dr. Tin O Maung, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 5999 Harpers Farm Rd Ste W250, Columbia, MD 21044 Phone: 410-772-8822 Fax: 410-772-9274 | |
Dr. Jeffery Wayne Van Den Broek, D.O. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 10710 Charter Dr, Suite 110, Columbia, MD 21044 Phone: 410-992-9797 Fax: 410-730-0942 |