Healthcare Provider Details

I. General information

NPI: 1730156530
Provider Name (Legal Business Name): MARIA HECK D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2006
Last Update Date: 09/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

870 E ARKONA RD SUITE 100
MILAN MI
48160-9770
US

IV. Provider business mailing address

24 FRANK LLOYD WRIGHT DR P.O. BOX 0446, LOBBY J
ANN ARBOR MI
48105-9484
US

V. Phone/Fax

Practice location:
  • Phone: 734-439-2429
  • Fax: 734-439-0200
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number5101015415
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: