Individual
MICHAEL HEDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1300 S US-89, HEBER, UT 84032
(435) 657-8000
(435) 657-8001
Mailing address
1150 N 500 W, ATTN CREDENTIALING, PROVO, UT 84604
(801) 354-8225
(801) 418-0941
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12292652-1204
UT
390200000X
Student in an Organized Health Care Education/Training Program
—
IL
Other
Enumeration date
06/23/2018
Last updated
07/27/2021
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