Provider Demographics
NPI:1194721803
Name:HARTZ, WILLIAM H (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:H
Last Name:HARTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:101 GREENWOOD AVE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:JENKINTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19046-2627
Mailing Address - Country:US
Mailing Address - Phone:215-379-8458
Mailing Address - Fax:267-620-1638
Practice Address - Street 1:H-42 OMEGA DRIVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713
Practice Address - Country:US
Practice Address - Phone:302-738-1700
Practice Address - Fax:302-738-0100
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.1328102085R0204X
PAMD022230E2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA000944944Medicaid
PA000944944Medicaid
PA434098Medicare PIN