Healthcare Provider Details

I. General information

NPI: 1770594947
Provider Name (Legal Business Name): MICHAEL DAVID HEIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 11/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 WAKE ROBIN RD SUITE 207
LINCOLN RI
02865-4295
US

IV. Provider business mailing address

2 WAKE ROBIN RD SUITE 207
LINCOLN RI
02865-4295
US

V. Phone/Fax

Practice location:
  • Phone: 401-334-2242
  • Fax: 401-334-0376
Mailing address:
  • Phone: 401-334-2242
  • Fax: 401-334-0376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberMD07593
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: