Individual
HEATHER LYNN FENNELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4201 CAMPUS RIDGE DR, MIDLAND, MI 48640-6128
(989) 837-9071
(989) 488-5783
Mailing address
4000 WELLNESS DR, MIDLAND, MI 48670-2000
(448) 321-9568
(989) 633-5241
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301514883
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/12/2019
Last updated
08/26/2025
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