Organization
KELLY M HEFFERON DO PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY M HEFFERON D.O. (DIRECTOR)
(248) 230-1780
Entity
Organization
Contact information
Practice address
5114 SHENANDOAH CT, W BLOOMFIELD, MI 48323-2343
(248) 230-1780
Mailing address
5114 SHENANDOAH CT, W BLOOMFIELD, MI 48323-2343
(248) 230-1780
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
208D00000X
General Practice Physician
—
—
Other
Enumeration date
04/27/2015
Last updated
10/15/2015
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