Provider Demographics
NPI:1285805895
Name:HUETTNER, WILLIAM CLIFFORD (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:CLIFFORD
Last Name:HUETTNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2111 MERRITT RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-6916
Mailing Address - Country:US
Mailing Address - Phone:517-332-4263
Mailing Address - Fax:517-332-1132
Practice Address - Street 1:2111 MERRITT RD
Practice Address - Street 2:SUITE 101
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-6916
Practice Address - Country:US
Practice Address - Phone:517-332-4263
Practice Address - Fax:517-332-1132
Is Sole Proprietor?:No
Enumeration Date:2008-03-23
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301076376208200000X, 2086S0105X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the Hand
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery