Individual
JAMES E HEISEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
4301052972
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300050548
RAILROAD MEDICARE
—
01
—
3003858362
BCBS OF MICHIGAN
MI
05
—
3146869
—
MI
01
—
4301052972
STATE OF MICHIGAN MEDICAL LICENSE
MI
Enumeration date
08/09/2005
Last updated
01/10/2017
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