Provider Demographics
NPI:1174523401
Name:PLUMER-HAUN, HEATHER M (DO)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:M
Last Name:PLUMER-HAUN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 187
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:MI
Mailing Address - Zip Code:48062-0187
Mailing Address - Country:US
Mailing Address - Phone:586-727-5840
Mailing Address - Fax:586-727-5897
Practice Address - Street 1:66707 GRATIOT AVE
Practice Address - Street 2:
Practice Address - City:LENOX
Practice Address - State:MI
Practice Address - Zip Code:48050-2019
Practice Address - Country:US
Practice Address - Phone:586-727-5840
Practice Address - Fax:586-727-5897
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-28
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101014179207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N74950003Medicare ID - Type Unspecified
MIH67700Medicare UPIN