| NPI Details | |
|---|---|
| NPI | 1013004373 |
| Gender | Female |
| Enumeration Date | 10/06/2006 |
| Last Updated | 07/08/2007 |
| Entity Type | Individual |
| Active | Over 11 years ago |
| Practice Location | |
|---|---|
| 2810 CHARLEVOIX AVE SUITE 104 PETOSKEY MI, 49770-8421, US |
|
| Phone | (231) 487-0970 |
| Fax | (231) 487-0979 |
| Business Location | |
|---|---|
| 2810 CHARLEVOIX AVE SUITE 104 PETOSKEY MI, 49770-8421, US |
|
| Phone | (231) 487-0970 |
| Fax | (231) 487-0979 |
| Toxanomy | |
|---|---|
| Taxonomy Code | 207VG0400X |
| License State | Michigan |
| License Number | CH045760 |
| Remove 1013004373 NPI Number | |
According to our database, Clare B Heidtke M.D. NPI is 1013004373, taxonomy code is 207VG0400X and license number is CH045760, license state is located at Michigan. Clare B Heidtke M.D. physically located at 2810 Charlevoix Ave, Petoskey MI, 49770-8421. NPI Number Clare B Heidtke M.D. has the Individual type.
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1013004373 NPI number is provided on an as is basis without warranty of any kind. 1013004373 is maintained by the National Plan & Provider Enumeration System. The contents of Clare B Heidtke M.D. are for informational purposes only.
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