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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MARK HERZOG, PTA

Active Sole Proprietor

MARK HERZOG, PTA is a General Acute Care Hospital healthcare provider located in SOUTHPORT, North Carolina. NPI 1447373766 is currently active in the NPPES registry. Verify at CMS.

General Acute Care Hospital · SOUTHPORT, NC

Registration Details

NPI Number
1447373766
Provider Type
Individual
Gender
Male
NPI Issued
Apr 10, 2007 (19.162077687618 yrs)
Last Updated
Jul 8, 2007
License
3211 (NC)
Sole Proprietor
Yes

Practice Information

Address
924 N HOWE ST
SOUTHPORT, NC, 284613038
Browse NC providers · Browse ZIP 28461
Phone
9104544703
Primary Specialty
General Acute Care Hospital
282N00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.