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General NPI Number Information
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NPI Number | 1881788552
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Entity Type | Individual
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Provider Name | CRAIG L HEINS M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/03/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 1621 N TAYLOR DR STE 300
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City | SHEBOYGAN
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State | WI
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Zip | 53081-1992
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Country | US
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Telephone | 920-458-4419
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Fax | 920-458-7516
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Provider Business Mailing Address
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Address Line | 1621 N TAYLOR DR STE 300
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City | SHEBOYGAN
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State | WI
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Zip | 53081-1992
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Country | US
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Telephone | 920-458-4419
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Fax | 920-458-7516
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 47379020
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License Number State | WI
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