Provider Demographics
NPI:1487608675
Name:HEYER, HAL B (MD)
Entity type:Individual
Prefix:
First Name:HAL
Middle Name:B
Last Name:HEYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:14700 28TH AVE N
Mailing Address - Street 2:SUITE 20
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55447-4835
Mailing Address - Country:US
Mailing Address - Phone:763-559-3779
Mailing Address - Fax:763-450-3986
Practice Address - Street 1:1420 LONDON RD
Practice Address - Street 2:SUITE 100
Practice Address - City:DULUTH
Practice Address - State:MN
Practice Address - Zip Code:55805-2433
Practice Address - Country:US
Practice Address - Phone:218-728-8548
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN26959207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MND48646Medicare UPIN