Organization Name: | DONALD P HEILALA DPM |
NPI Number: | 1518145440 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DONALD P HEILALA (PODIATRIST) |
Mailing Address: | 844 Pyle Dr Kingsford |
State: | MI US |
Postal Code: | 498024455 |
Phone Number: | 9067741155 |
Fax Number: | |
NPI Enumeration Date: | 02/01/2008 |
NPI Last Update Date: | 04/25/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | 5901001173 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |