Healthcare Provider Details
I. General information
NPI: 1306136411
Provider Name (Legal Business Name): ANNE-MARIE E SIRANY HEGMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/10/2011
Last Update Date: 12/11/2024
Certification Date: 12/11/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6565 FRANCE AVE S STE 375
EDINA MN
55435
US
IV. Provider business mailing address
3433 BROADWAY ST NE STE 115
MINNEAPOLIS MN
55413-1759
US
V. Phone/Fax
- Phone: 651-312-1700
- Fax: 651-312-1570
- Phone: 651-312-1505
- Fax: 612-248-2944
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208C00000X |
| Taxonomy | Colon & Rectal Surgery Physician |
| License Number | 56425 |
| License Number State | MN |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: