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General NPI Number Information
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NPI Number | 1376544593
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Entity Type | Individual
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Provider Name | STEVEN J HEITHOFF D.O.
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Gender | Male
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Dates
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Enumeration Date | 08/10/2005
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 940 RIVER CENTRE DR
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City | PORT HURON
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State | MI
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Zip | 48060-4463
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Country | US
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Telephone | 810-985-4900
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Fax | 810-985-3634
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Provider Business Mailing Address
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Address Line | 940 RIVER CENTRE DR
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City | PORT HURON
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State | MI
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Zip | 48060-4463
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Country | US
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Telephone | 810-985-4900
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Fax | 810-985-3634
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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 | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number | 5101007945
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License Number State | MI
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