Provider Demographics
NPI:1124133400
Name:HEM, HALVOR (MD)
Entity type:Individual
Prefix:DR
First Name:HALVOR
Middle Name:
Last Name:HEM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:HALVOR
Other - Middle Name:
Other - Last Name:HEM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 1810
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39502-1810
Mailing Address - Country:US
Mailing Address - Phone:228-868-4287
Mailing Address - Fax:228-868-4293
Practice Address - Street 1:5120 BEATLINE RD
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:MS
Practice Address - Zip Code:39560-3815
Practice Address - Country:US
Practice Address - Phone:228-864-8454
Practice Address - Fax:228-865-1457
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2014-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS16075207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSP00651246OtherRAILROAD MEDICARE
MS110173510OtherRAILROAD MEDICARE
MS00119740Medicaid
MSP00651246OtherRAILROAD MEDICARE
MS$$$$$$$$$AOtherBCBS
MS512I110237Medicare PIN
MS$$$$$$$$$OtherBCBS
MS$$$$$$$$$AOtherBCBS
MS302I115948Medicare PIN