Healthcare Provider Details

I. General information

NPI: 1174657449
Provider Name (Legal Business Name): BRIAN D HEYMAN, DO, PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10683 S SAGINAW ST STE B
GRAND BLANC MI
48439-8127
US

IV. Provider business mailing address

10683 S SAGINAW ST STE B
GRAND BLANC MI
48439-8127
US

V. Phone/Fax

Practice location:
  • Phone: 810-695-9920
  • Fax:
Mailing address:
  • Phone: 810-695-9920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number5101014587
License Number StateMI

VIII. Authorized Official

Name: DR. BRIAN HEYMAN
Title or Position: MEMBER
Credential: D.O.
Phone: 810-695-9920