Healthcare Provider Details

I. General information

NPI: 1336379569
Provider Name (Legal Business Name): ANNA HEHL-BISSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2009
Last Update Date: 03/16/2021
Certification Date: 03/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3132 NEWPORT RD NORTH PARK PLAZA
NEWPORT MI
48166-6100
US

IV. Provider business mailing address

26901 BEAUMONT BLVD STE 3D
SOUTHFIELD MI
48033-3849
US

V. Phone/Fax

Practice location:
  • Phone: 734-586-9120
  • Fax:
Mailing address:
  • Phone: 947-522-1863
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301095034
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: