Individual
DR. MICHAEL HEGSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
420 DELAWARE ST SE, MINNEAPOLIS, MN 55455-0341
(612) 626-0622
(612) 625-4411
Mailing address
7222 KIMBERLY LN N, MAPLE GROVE, MN 55311-4563
(612) 360-3910
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
14024660-1205
UT
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/23/2020
Last updated
03/27/2026
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