Individual
DR. KIMBERLY A HEGEWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3537 W FRONT ST STE G, TRAVERSE CITY, MI 49684-7943
(231) 935-8822
Mailing address
3537 W FRONT ST STE G, TRAVERSE CITY, MI 49684-7943
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301075523
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4290606
—
MI
Enumeration date
01/03/2006
Last updated
12/21/2020
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