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General NPI Number Information
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NPI Number | 1437670338
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Entity Type | Individual
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Provider Name | MICHAEL HEATH MD
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Gender | Male
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Dates
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Enumeration Date | 06/29/2017
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Last Update Date | 09/18/2025
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Provider Practice Location Address
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Address Line | 2440 NW EDENBOWER BLVD
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City | ROSEBURG
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State | OR
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Zip | 97471-8847
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Country | US
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Telephone | 541-957-1141
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Fax | 541-957-1466
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Provider Business Mailing Address
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Address Line | 2440 NW EDENBOWER BLVD
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City | ROSEBURG
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State | OR
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Zip | 97471-8847
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Country | US
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Telephone | 541-957-1141
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Fax | 541-957-1466
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | MD215326
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 313363
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number | MD215326
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License Number State | OR
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Taxonomy #4
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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