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DR. TIMOTHY D HENNE M.D.

Physicians - Orthopaedic Surgery Sports Medicine

Grand Rapids, Michigan

Provider NPI: 1730125428

Provider Information:
DR. TIMOTHY D HENNE M.D.


Practice Location:
350 LAFAYETTE AVE SE 5TH FLOOR GRAND RAPIDS, MI 49503 US
Tel: 616-459-9404  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207XX0005XPhysicians
Orthopaedic Surgery
Sports Medicine
MI4301072748

Other Provider Identifiers:

IssuerNumberStateType
4630898MI05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin



ORTHOPAEDIC SURGERY JOBS MI - Page 1



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