Individual
ELIZABETH HENGSTEBECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
804 SERVICE RD, A142, EAST LANSING, MI 48824-7015
(517) 353-3050
(517) 432-3742
Mailing address
804 SERVICE RD, A201, EAST LANSING, MI 48824-7015
(517) 884-2976
(517) 432-3928
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101012728
MI
207Q00000X
Family Medicine Physician
OS8643
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1457355042
—
MI
05
—
265730900
—
FL
01
—
47880Y
MEDICARE PART B, PTAN
FL
01
—
99388
MEDICARE PART B, GROUP PTAN
FL
Enumeration date
06/10/2005
Last updated
03/08/2017
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