Michael T. Hegstrom,MD, PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

21695 Issued in WV

Legal business name

MICHAEL T. HEGSTROM,MD, PLLC

Practice address

510 Cherry Street
Suite 206, BLGD. a
Bluefield, WV 24701-3341

Phone

(304) 327-1888

Fax

(304) 327-1889

NPI assigned

Jan 10, 2007

Last updated

Aug 9, 2011By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Michael Terrance Hegstrom, MD

Title

Physician

Phone

(304) 327-1888

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312848000000",
    "number": "1942359401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 CHERRY ST",
            "address_2": "SUITE 206, BLDG A",
            "city": "BLUEFIELD",
            "state": "WV",
            "postal_code": "247013338",
            "telephone_number": "304-327-1888",
            "fax_number": "304-327-1889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 CHERRY STREET",
            "address_2": "SUITE 206, BLGD. A",
            "city": "BLUEFIELD",
            "state": "WV",
            "postal_code": "247013341",
            "telephone_number": "304-327-1888",
            "fax_number": "304-327-1889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL T. HEGSTROM,MD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2011-08-09",
        "status": "A",
        "authorized_official_last_name": "HEGSTROM",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "TERRANCE",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "304-327-1888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WV",
            "license": "21695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810001358",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Bluefield, WV
• Providers in Bluefield, WV by specialty
• Specialist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.