Individual
MICHAEL D HEDEMARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
520 S EAGLE RD, SUITE 3102, MERIDIAN, ID 83642-6351
(208) 706-5100
(208) 706-5169
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M-9924
ID
207R00000X
Internal Medicine Physician
ML20008230
WA
Other
Enumeration date
09/22/2006
Last updated
01/23/2014
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