Provider Demographics
NPI:1770594947
Name:HEIN, MICHAEL DAVID (MD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DAVID
Last Name:HEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2 WAKE ROBIN RD
Mailing Address - Street 2:SUITE 207
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-4295
Mailing Address - Country:US
Mailing Address - Phone:401-334-2242
Mailing Address - Fax:401-334-0376
Practice Address - Street 1:2 WAKE ROBIN RD
Practice Address - Street 2:SUITE 207
Practice Address - City:LINCOLN
Practice Address - State:RI
Practice Address - Zip Code:02865-4295
Practice Address - Country:US
Practice Address - Phone:401-334-2242
Practice Address - Fax:401-334-0376
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RIMD07593207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI050503963OtherTAX ID
RID80824Medicare UPIN