Healthcare Provider Details

I. General information

NPI: 1609820216
Provider Name (Legal Business Name): HOWARD J HEINZE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 01/23/2025
Certification Date: 01/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2215 LANGHORNE RD
LYNCHBURG VA
24501-1121
US

IV. Provider business mailing address

2215 LANGHORNE RD
LYNCHBURG VA
24501-1121
US

V. Phone/Fax

Practice location:
  • Phone: 434-948-4831
  • Fax:
Mailing address:
  • Phone: 434-948-4831
  • Fax: 302-651-4945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number057475
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101262635
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: