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Individual

JANICE B HEIKENEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
6287 LAGOON LANE, BOX 439, MOHAWK, MI 49950
(906) 289-4316
Mailing address
6287 LAGOON LANE, BOX 439, MOHAWK, MI 49950-0439
(906) 289-4316

Taxonomy

Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
32580
WI
2080P0206X
Pediatric Gastroenterology Physician
4301089369
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
31957600
WI
05
5345324
MI
01
700C610000
BCBS OF MI
MI
Enumeration date
09/25/2006
Last updated
11/15/2013
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