Individual
ERIK HEDLUND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1111 LEFFINGWELL AVE NE, GRAND RAPIDS, MI 49525-6406
(616) 459-7101
Mailing address
1111 LEFFINGWELL AVE NE, GRAND RAPIDS, MI 49525-6406
(616) 459-7101
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
5101013947
MI
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
5101013947
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D14869120
MEDICARE PTAN
MI
01
—
PO1223799
MEDICARE RAILROAD
MI
Enumeration date
06/04/2006
Last updated
01/03/2014
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