Provider Demographics
NPI:1003012055
Name:MICHAEL A. HENNGIAN, M.D., P.C
Entity Type:Organization
Organization Name:MICHAEL A. HENNGIAN, M.D., P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:HENNGIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-351-1990
Mailing Address - Street 1:1310 14TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35601-4347
Mailing Address - Country:US
Mailing Address - Phone:256-351-1990
Mailing Address - Fax:
Practice Address - Street 1:1310 14TH AVE SE
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35601-4347
Practice Address - Country:US
Practice Address - Phone:256-351-1990
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty