Individual
MICHELLE HENGGELER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
900 CATON AVE, BALTIMORE, MD 21229-5201
(904) 805-1300
(904) 805-1302
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
D53312
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145602400
—
MD
01
—
60609101
BLUE CROSS
MD
01
—
D53312
MD LICENSE
MD
01
—
P00205778
RAILROAD MEDICARE
MD
Enumeration date
06/14/2006
Last updated
02/24/2022
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