MEDICARE: DR. HEIDI HARRINGTON DELEON 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	208200000X	Plastic Surgery Physician	MD19151	ME
2	208200000X	Plastic Surgery Physician	16908	NH
3	208200000X	Plastic Surgery Physician	92996	SC

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	:	1326241522
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HEIDI HARRINGTON DELEON M.D.

Provider Business Mailing Address
First Line	:	789 CENTRAL AVE
Second Line	:
City	:	DOVER
State	:	NH
Zip	:	03820-2526
Country	:	US
Telephone Number	:	603-516-4268
Fax Number	:

Provider Business Practice Location Address
First Line	:	122 OKATIE CENTER BLVD N STE 220
Second Line	:
City	:	OKATIE
State	:	SC
Zip	:	29909-3782
Country	:	US
Telephone Number	:	843-707-8020
Fax Number	:

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

Provider Enumeration Date	:	06/06/2007
Last Update Date	:	08/29/2024

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