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General NPI Number Information
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NPI Number | 1326241522
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Entity Type | Individual
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Provider Name | HEIDI HARRINGTON DELEON M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/06/2007
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Last Update Date | 08/29/2024
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Provider Practice Location Address
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Address Line | 122 OKATIE CENTER BLVD N STE 220
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City | OKATIE
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State | SC
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Zip | 29909-3782
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Country | US
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Telephone | 843-707-8020
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Fax |
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Provider Business Mailing Address
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Address Line | 789 CENTRAL AVE
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City | DOVER
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State | NH
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Zip | 03820-2526
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Country | US
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Telephone | 603-516-4268
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Fax |
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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 | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | MD19151
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 16908
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License Number State | NH
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Taxonomy #3
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 92996
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License Number State | SC
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