Provider Demographics
NPI:1558397810
Name:HEGENER, MICHAEL ALLEN (PHARMD, BCACP)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ALLEN
Last Name:HEGENER
Suffix:
Gender:M
Credentials:PHARMD, BCACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UNIVERSITY OF CINCINNATI COLLEGE OF PHARMACY
Mailing Address - Street 2:3225 EDEN AVENUE
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45267-0004
Mailing Address - Country:US
Mailing Address - Phone:513-558-7806
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF CINCINNATI COLLEGE OF PHARMACY
Practice Address - Street 2:3225 EDEN AVENUE
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45267-0004
Practice Address - Country:US
Practice Address - Phone:513-558-7806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY012892183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist