Provider Demographics
NPI:1568431435
Name:HOEKSEMA, HERMAN D (MD)
Entity Type:Individual
Prefix:
First Name:HERMAN
Middle Name:D
Last Name:HOEKSEMA
Suffix:
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 1:1675 LEAHY ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49442-5500
Mailing Address - Country:US
Mailing Address - Phone:231-722-7245
Mailing Address - Fax:231-722-6103
Practice Address - Street 1:1675 LEAHY ST
Practice Address - Street 2:SUITE 120
Practice Address - City:MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49442-5500
Practice Address - Country:US
Practice Address - Phone:231-722-7245
Practice Address - Fax:231-722-6103
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MIHH030264207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1361615Medicaid
B47143Medicare UPIN
0F16382001Medicare ID - Type Unspecified