Provider Demographics
NPI:1124171889
Name:HEGGENESS, STEVEN T (MD)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:T
Last Name:HEGGENESS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1329 LUSITANA STREET
Mailing Address - Street 2:SUITE 604
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2431
Mailing Address - Country:US
Mailing Address - Phone:808-531-1116
Mailing Address - Fax:808-524-7911
Practice Address - Street 1:1329 LUSITANA STREET
Practice Address - Street 2:SUITE 604
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2431
Practice Address - Country:US
Practice Address - Phone:808-531-1116
Practice Address - Fax:808-524-7911
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HIMD7627207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI07132301Medicaid
HIH0000BDSZBMedicare ID - Type Unspecified
HI07132301Medicaid