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General NPI Number Information
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NPI Number | 1073204277
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Entity Type | Organization
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Legal Business Name | HEIDI A HERAS MDPC
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Dates
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Enumeration Date | 05/17/2023
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Last Update Date | 05/17/2023
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Provider Practice Location Address
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Address Line | 482 W 50 N # 14
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City | AMERICAN FORK
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State | UT
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Zip | 84003-2266
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Country | US
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Telephone | 801-492-7662
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Fax | 801-492-7663
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Provider Business Mailing Address
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Address Line | 482 W 50 N # 14
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City | AMERICAN FORK
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State | UT
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Zip | 84003-2266
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Country | US
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Telephone | 801-492-7662
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Fax | 801-492-7663
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Authorized Official
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Title or Position | OWNER
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Name | HEIDI HERAS
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Credential | MD
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Telephone | 801-895-5700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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