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General NPI Number Information
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NPI Number | 1497732804
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Entity Type | Individual
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Provider Name | STEVEN HEIFETZ M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/28/2005
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Last Update Date | 05/24/2012
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Provider Practice Location Address
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Address Line | 6405 FRANCE AVE S STE W200
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City | EDINA
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State | MN
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Zip | 55435
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Country | US
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Telephone | 952-915-2454
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Fax | 952-924-0330
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Provider Business Mailing Address
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Address Line | 6405 FRANCE AVE S STE W200
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City | EDINA
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State | MN
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Zip | 55435
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Country | US
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Telephone | 952-915-2454
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Fax | 952-924-0330
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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 | 30617
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License Number State | MN
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