Healthcare Provider Details

I. General information

NPI: 1336118066
Provider Name (Legal Business Name): RICHARD EDWARD HEYWOOD III D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2006
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 BATES RD STE 202
MASHPEE MA
02649
US

IV. Provider business mailing address

34 BATES RD STE 202
MASHPEE MA
02649-3280
US

V. Phone/Fax

Practice location:
  • Phone: 508-681-5081
  • Fax: 877-669-1746
Mailing address:
  • Phone: 508-681-5081
  • Fax: 877-669-1746

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number0102201759
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number247143
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: