Individual
DYLAN THOMAS HENGST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
DO-55693
IA
207R00000X
Internal Medicine Physician
R-12880
IA
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
10/17/2016
Last updated
06/17/2026
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