Individual
MARGAUX MAE HETZMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3950 KRESGE WAY STE 308, LOUISVILLE, KY 40207-4637
(502) 852-5666
(502) 852-8980
Mailing address
3950 KRESGE WAY STE 308, LOUISVILLE, KY 40207-4637
(502) 895-8911
(502) 895-8977
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
55566
KY
207R00000X
Internal Medicine Physician
TP049
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100606960
—
KY
Enumeration date
04/26/2018
Last updated
06/25/2021
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