Provider Demographics
NPI:1215044565
Name:HELIGMAN, RICHARD (DPM PC)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:
Last Name:HELIGMAN
Suffix:
Gender:M
Credentials:DPM PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2954 INTERLAKEN ST
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48323-1817
Mailing Address - Country:US
Mailing Address - Phone:248-788-5891
Mailing Address - Fax:248-682-3003
Practice Address - Street 1:2954 INTERLAKEN ST
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48323-1817
Practice Address - Country:US
Practice Address - Phone:248-788-5891
Practice Address - Fax:248-682-3003
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI000893213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4238295Medicaid
MIT34342Medicare UPIN
MI4238295Medicaid
MI791480415Medicare PIN