Hegewald, Montgomery John
Hegewald, Montgomery John is an individual health care provider with primary practice located at 4100 Park Forest Dr Suite 208, Traverse City MI 49684-7331. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Hegewald, Montgomery John can be contacted via phone (231) 935-5710.Contact Information
Primary practice address
4100 Park Forest Dr Suite 208
Traverse City MI 49684-7331
Phone: (231) 935-5710
Fax: (231) 935-9045
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | MH075535 | Michigan |
Profile Details
| NPI number | 1205902095 |
|---|---|
| LBN Legal business name | Hegewald, Montgomery John |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 26th, 2006 |
| Last updated | Aug 29th, 2008 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1205902095 | NPPES |
| Michigan | MEDICAID | 4239855 | |
| Michigan | Other | OB81010 |
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