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General NPI Number Information
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NPI Number | 1043066616
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Entity Type | Individual
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Provider Name | MICHAEL VINCENT HEILMAN PA-C
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Gender | Male
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Dates
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Enumeration Date | 04/25/2024
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 96 ATLANTIC AVE STE 101
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City | OCEAN VIEW
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State | DE
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Zip | 19970-9103
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Country | US
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Telephone | 302-541-4460
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Fax | 302-541-0124
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Provider Business Mailing Address
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Address Line | 10026 OLD OCEAN CITY BLVD
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City | BERLIN
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State | MD
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Zip | 21811-9515
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Country | US
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Telephone | 410-641-9450
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Fax | 410-641-9515
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | C5-0012057
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | C0009370
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | C0009370
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | C5-0012057
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License Number State | DE
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