Provider Demographics
NPI:1326156928
Name:HESSLER, GREGORY HUGH (M D)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:HUGH
Last Name:HESSLER
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 N. STATE STREET
Mailing Address - Street 2:
Mailing Address - City:SAINT IGNACE
Mailing Address - State:MI
Mailing Address - Zip Code:48781
Mailing Address - Country:US
Mailing Address - Phone:906-643-0466
Mailing Address - Fax:231-534-7460
Practice Address - Street 1:7474 MARKET STREET
Practice Address - Street 2:
Practice Address - City:MACKINAC ISLAND
Practice Address - State:MI
Practice Address - Zip Code:49757
Practice Address - Country:US
Practice Address - Phone:231-534-7200
Practice Address - Fax:231-534-7460
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301048874207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
B48573Medicare UPIN
ON65080Medicare ID - Type Unspecified