Provider Demographics
NPI:1669607040
Name:HEHEMANN, DAVID T (DPM)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:T
Last Name:HEHEMANN
Suffix:
Gender:M
Credentials:DPM
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 480
Mailing Address - Street 2:
Mailing Address - City:DAVISON
Mailing Address - State:MI
Mailing Address - Zip Code:48423-0480
Mailing Address - Country:US
Mailing Address - Phone:810-653-9060
Mailing Address - Fax:810-658-2248
Practice Address - Street 1:605 S STATE RD
Practice Address - Street 2:
Practice Address - City:DAVISON
Practice Address - State:MI
Practice Address - Zip Code:48423-1515
Practice Address - Country:US
Practice Address - Phone:810-653-9060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36.003614213ES0103X
KY00399213ES0103X
MI5901002671213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP01105232OtherRR MEDICARE- BAPTIST HEALTH MADISONVILLE INC
KY7100223580Medicaid
KY000000788606OtherBCBS- BAPTIST HEALTH MADISONVILLE INC
KYK057343Medicare PIN
KYK057341Medicare PIN
KY7100223580Medicaid