Healthcare Provider Details

I. General information

NPI: 1346697398
Provider Name (Legal Business Name): DARYA HEIM M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2016
Last Update Date: 07/10/2020
Certification Date: 07/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 LAKE ST, BROSSMAN CENTER FOR HEALTH
EPHRATA PA
17522-2415
US

IV. Provider business mailing address

3421 CONCORD RD
YORK PA
17402-9001
US

V. Phone/Fax

Practice location:
  • Phone: 717-721-7718
  • Fax: 717-721-7726
Mailing address:
  • Phone: 717-721-7718
  • Fax: 717-721-7726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD466836
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: