Healthcare Provider Details
I. General information
NPI: 1205946001
Provider Name (Legal Business Name): MICHAEL ALEXANDER HEYMANN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
175 CORONA RD
CARMEL CA
93923-9600
US
IV. Provider business mailing address
PO BOX 222437
CARMEL CA
93922-2437
US
V. Phone/Fax
- Phone: 831-626-8473
- Fax: 831-626-6893
- Phone: 831-626-8473
- Fax: 831-626-6893
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2080P0202X |
| Taxonomy | Pediatric Cardiology Physician |
| License Number | A23938 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: