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General NPI Number Information
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NPI Number | 1477560126
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Entity Type | Individual
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Provider Name | RAFE M HENG D.O., FACC
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Gender | Male
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Dates
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Enumeration Date | 08/02/2006
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Last Update Date | 06/04/2020
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Provider Practice Location Address
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Address Line | 6812 STATE RTE 162 SUITE 202
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City | MARYVILLE
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State | IL
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Zip | 62062
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Country | US
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Telephone | 618-288-1748
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Fax | 618-288-1768
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Provider Business Mailing Address
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Address Line | 6812 STATE RTE 162 SUITE 202
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City | MARYVILLE
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State | IL
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Zip | 62062
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Country | US
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Telephone | 618-288-1748
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Fax | 618-288-1768
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 036113077
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License Number State | IL
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