Individual
GARY M HEGRANES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
110 E 5TH AVE, ANTIGO, WI 54409-2710
(715) 623-2351
Mailing address
3000 WESTHILL DR, SUITE 303, WAUSAU, WI 54401-3795
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
26799
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30674700
—
WI
Enumeration date
07/10/2006
Last updated
07/08/2007
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