Provider Demographics
NPI:1417956186
Name:HEILBRONN, DUANE B JR (MD)
Entity Type:Individual
Prefix:DR
First Name:DUANE
Middle Name:B
Last Name:HEILBRONN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:926 N MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-4323
Mailing Address - Country:US
Mailing Address - Phone:989-753-8453
Mailing Address - Fax:989-753-3519
Practice Address - Street 1:926 N MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48602-4323
Practice Address - Country:US
Practice Address - Phone:989-753-8453
Practice Address - Fax:989-753-3519
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2010-04-19
Deactivation Date:2006-03-18
Deactivation Code:
Reactivation Date:2006-03-31
Provider Licenses
StateLicense IDTaxonomies
MIDH050434207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2839975Medicaid
MI0G36028Medicare PIN
MI2839975Medicaid