Healthcare Provider Details
I. General information
NPI: 1124119169
Provider Name (Legal Business Name): PATRICK STANLEY HEIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/27/2006
Last Update Date: 05/22/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3333 W TECH RD STE 120
MIAMISBURG OH
45342-0956
US
IV. Provider business mailing address
PO BOX 933432
CLEVELAND OH
44193-0039
US
V. Phone/Fax
- Phone: 937-748-6116
- Fax: 937-291-6956
- Phone: 937-641-3555
- Fax: 937-641-4528
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 35075410 |
| License Number State | OH |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: