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Individual

DR. MATTHEW W HEDGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4201 SAINT ANTOINE ST, SUITE 3R, DETROIT, MI 48201-2153
(313) 745-3040
Mailing address
4201 SAINT ANTOINE ST, SUITE 3R, DETROIT, MI 48201-2153
(313) 745-3040

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301074981
MI
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
4301074981
MI
207PT0002X
Medical Toxicology (Emergency Medicine) Physician
4301074981
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
104431114
MI
01
MH074981
BC/BS OF MI
MI
Enumeration date
03/17/2006
Last updated
06/18/2010
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