Provider Demographics
NPI:1508839820
Name:HELLNER, ROBERT HENRY (CPO)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:HENRY
Last Name:HELLNER
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2233 EULER RD
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48114-7411
Mailing Address - Country:US
Mailing Address - Phone:810-220-3472
Mailing Address - Fax:810-220-8232
Practice Address - Street 1:2233 EULER RD
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48114-7411
Practice Address - Country:US
Practice Address - Phone:810-220-3472
Practice Address - Fax:810-220-8232
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-08
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1744P3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI500740OtherPREFERRED CHOICES
MI500740OtherCARE CHOICES
MI3169273Medicaid
MI631OtherNORTHWOOD
MI3169273Medicaid