Provider Demographics
NPI:1164089637
Name:HERMEZ, KLODIA (DO)
Entity type:Individual
Prefix:DR
First Name:KLODIA
Middle Name:
Last Name:HERMEZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27901 WOODWARD AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:BERKLEY
Mailing Address - State:MI
Mailing Address - Zip Code:48072-0918
Mailing Address - Country:US
Mailing Address - Phone:248-414-5377
Mailing Address - Fax:
Practice Address - Street 1:27901 WOODWARD AVE STE 210
Practice Address - Street 2:
Practice Address - City:BERKLEY
Practice Address - State:MI
Practice Address - Zip Code:48072-0918
Practice Address - Country:US
Practice Address - Phone:248-414-5377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-21
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101025728207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology