Healthcare Provider Details

I. General information

NPI: 1821364043
Provider Name (Legal Business Name): MICHAEL K HECK DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2012
Last Update Date: 12/31/2025
Certification Date: 12/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1237 W DIVIDE AVE STE 5
BISMARCK ND
58501-1208
US

IV. Provider business mailing address

1410 INCARNATION DR STE 206
CHARLOTTESVILLE VA
22901-5708
US

V. Phone/Fax

Practice location:
  • Phone: 701-328-8888
  • Fax: 701-328-8900
Mailing address:
  • Phone: 434-260-1296
  • Fax: 844-804-3071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0102203941
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number0102203941
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: