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Individual

MARK E. HEGGEM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
200 BUNKER HILL DR, AITKIN, MN 56431-1865
(218) 927-2157
(218) 927-4130
Mailing address
200 BUNKER HILL DR, AITKIN, MN 56431-1865
(218) 927-2157
(218) 927-4130

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
30111
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080005304
MEDICARE WPS - MCGREGOR C
MN
01
080005305
MEDICARE WPS - AITKIN CLI
MN
01
080015859
MEDICARE WPS - GARRISON C
MN
01
089000098
MEDICARE WPS - HOSPITAL
MN
05
882390100
MN
Enumeration date
03/02/2006
Last updated
03/13/2013
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