Provider Demographics
NPI:1548759830
Name:HEGGUM, HEGE FINVOLD (MD)
Entity Type:Individual
Prefix:MRS
First Name:HEGE
Middle Name:FINVOLD
Last Name:HEGGUM
Suffix:
Gender:F
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:HENRY FORD HOSPITAL, MEDICAL EDUCATION DEPARTMENT
Mailing Address - Street 2:2799 W. GRAND BOULEVARD
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202
Mailing Address - Country:US
Mailing Address - Phone:313-874-5378
Mailing Address - Fax:
Practice Address - Street 1:HENRY FORD HOSPITAL, MEDICAL EDUCATION DEPARTMENT
Practice Address - Street 2:2799 W. GRAND BOULEVARD
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202
Practice Address - Country:US
Practice Address - Phone:313-874-5378
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-02
Last Update Date:2019-01-22
Deactivation Date:2018-12-13
Deactivation Code:
Reactivation Date:2019-01-22
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program