Healthcare Provider Details

I. General information

NPI: 1669607040
Provider Name (Legal Business Name): DAVID T HEHEMANN DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2009
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 S STATE RD
DAVISON MI
48423-1515
US

IV. Provider business mailing address

PO BOX 480
DAVISON MI
48423-0480
US

V. Phone/Fax

Practice location:
  • Phone: 810-653-9060
  • Fax:
Mailing address:
  • Phone: 810-653-9060
  • Fax: 810-658-2248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number36.003614
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number00399
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number5901002671
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: