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NPI Code Detail

MEDICARE: DUSTIN HEJDAK MD

MEDICARE: DUSTIN HEJDAK MD
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
12084P0800XPsychiatry Physician77051-20WI

General Provider Information

NPI Number : 1881273290
Entity Type Code : Individual
Provider Name (Legal Business Name) : DUSTIN HEJDAK MD
Provider Business Mailing Address
First Line : 12760 W NORTH AVE BLDG A
Second Line :
City : BROOKFIELD
State : WI
Zip : 53005-4628
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11101 W LINCOLN AVE
Second Line :
City : MILWAUKEE
State : WI
Zip : 53227-1133
Country : US
Telephone Number : 800-767-4411
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2021
Last Update Date : 09/25/2025

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