Healthcare Provider Details

I. General information

NPI: 1275595654
Provider Name (Legal Business Name): WILLIAM T HECK HMC(SW/FMF), IDC
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/03/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MEDICAL DEPARTMENT USS RAMAGE (DDG 61)
FPO AE
09586-1279
US

IV. Provider business mailing address

1200 BRAHMS DR
VIRGINIA BEACH VA
23454-6612
US

V. Phone/Fax

Practice location:
  • Phone: 757-445-0883
  • Fax: 757-445-0792
Mailing address:
  • Phone: 757-445-0803
  • Fax: 757-445-0792

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1710I1002X
TaxonomyIndependent Duty Corpsman
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: