MEDICARE: DR. WILLIAM V. HEHEMANN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	01020248A	IN

General Provider Information

NPI Number	:	1306892310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM V. HEHEMANN M.D.

Provider Business Mailing Address
First Line	:	7905 CALUMET AVE
Second Line	:
City	:	MUNSTER
State	:	IN
Zip	:	46321-1215
Country	:	US
Telephone Number	:	219-836-7214
Fax Number	:	219-836-6436

Provider Business Practice Location Address
First Line	:	7905 CALUMET AVE
Second Line	:
City	:	MUNSTER
State	:	IN
Zip	:	46321-1215
Country	:	US
Telephone Number	:	219-836-7214
Fax Number	:	219-836-6436

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/25/2006
Last Update Date	:	07/08/2007

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