MEDICARE: DR. ERIC WARREN HEIN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207WX0110X	Pediatric Ophthalmology and Strabismus Specialist Physician	2010-10965	NC
2	207W00000X	Ophthalmology Physician	168596	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245277532
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC WARREN HEIN M.D.

Provider Business Mailing Address
First Line	:	2554 LEWISVILLE-CLEMMONS ROAD
Second Line	:	SUITE 308
City	:	CLEMMONS
State	:	NC
Zip	:	27012-8749
Country	:	US
Telephone Number	:	336-245-8320
Fax Number	:	336-293-4857

Provider Business Practice Location Address
First Line	:	2554 LEWISVILLE CLEMMONS RD STE 308
Second Line	:
City	:	CLEMMONS
State	:	NC
Zip	:	27012-8749
Country	:	US
Telephone Number	:	336-245-8320
Fax Number	:	336-293-4857

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2006
Last Update Date	:	07/21/2022

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