Individual
DR. VON SCOTT HIENEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
6739 FULTON ST E, STE A-20, ADA, MI 49301-8138
(616) 676-2015
(616) 676-2011
Mailing address
6739 FULTON ST E, STE. A-20, ADA, MI 49301-8138
(616) 676-2015
(616) 676-2011
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901003820
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20235
SPECTERA
MI
01
—
38-3455751
EYEMED
MI
01
—
383455751
VSP IDENTIFIER
MI
05
—
4540404
—
MI
01
—
90 OD 166250
BCBS
MI
Enumeration date
12/05/2006
Last updated
11/29/2010
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