Individual
JOHN HEEMSTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10343 DAWSONS CREEK BLVD, FORT WAYNE, IN 46825-1906
(260) 203-9600
(260) 739-6167
Mailing address
10343 DAWSONS CREEK BLVD, FORT WAYNE, IN 46825-1906
(260) 739-6167
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
01079987A
IN
207P00000X
Emergency Medicine Physician
4301108240
MI
Other
Enumeration date
07/01/2015
Last updated
06/26/2018
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