Healthcare Provider Details

I. General information

NPI: 1306197793
Provider Name (Legal Business Name): HEIDI ROSE HINDSLEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2012
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 E MEDICAL CENTER DR SPC 5368
ANN ARBOR MI
48109-5368
US

IV. Provider business mailing address

1500 E MEDICAL CENTER DR SPC 5322
ANN ARBOR MI
48109-5322
US

V. Phone/Fax

Practice location:
  • Phone: 734-998-2020
  • Fax:
Mailing address:
  • Phone: 734-936-9020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number4351053023
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number4351053023
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: