Healthcare Provider Details

I. General information

NPI: 1003005950
Provider Name (Legal Business Name): HEIDI WORTH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MRS. HEIDI W. DICKSTEIN

II. Dates (important events)

Enumeration Date: 10/16/2007
Last Update Date: 05/12/2025
Certification Date: 05/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

291 HUFF DR
JACKSONVILLE NC
28546-7370
US

IV. Provider business mailing address

117 PARTRIDGE DR
NEW BERN NC
28562-8698
US

V. Phone/Fax

Practice location:
  • Phone: 910-347-2205
  • Fax:
Mailing address:
  • Phone: 970-390-6681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number46106
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number112090
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number2022-00969
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: