Healthcare Provider Details

I. General information

NPI: 1710336318
Provider Name (Legal Business Name): HEIDI A HEAP-CHESTER MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2016
Last Update Date: 06/17/2024
Certification Date: 06/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 SKY VIEW DR
CUMBERLAND FORESIDE ME
04110-1472
US

IV. Provider business mailing address

PO BOX 113
BRUNSWICK ME
04011-0113
US

V. Phone/Fax

Practice location:
  • Phone: 207-699-3830
  • Fax: 207-699-3831
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. HEIDI ANNE HEAP-CHESTER
Title or Position: OWNER
Credential: M.D.
Phone: 207-844-3170