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
Fax: (231) 935-9045
Website:

Health care specialties

SpecialtyCodeLicense #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 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205902095 NPPES
Michigan MEDICAID 4239855
Michigan Other OB81010

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