Healthcare Provider Details

I. General information

NPI: 1033299680
Provider Name (Legal Business Name): JOEL H HELLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 01/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603A DOLLEY MADISON RD
GREENSBORO NC
27410-4205
US

IV. Provider business mailing address

PO BOX 14883
GREENSBORO NC
27415-4883
US

V. Phone/Fax

Practice location:
  • Phone: 336-294-6190
  • Fax: 336-294-6278
Mailing address:
  • Phone: 336-294-6190
  • Fax: 336-294-6278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20605
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: