MEDICARE: DR. STEVEN WALTER HEINZ DC

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	111N00000X	Chiropractor	2301005737	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0E052290	OTHER	MI	BCBS
2	950E052290	OTHER	MI	BCBSM

General Provider Information

NPI Number	:	1396726469
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN WALTER HEINZ DC

Provider Business Mailing Address
First Line	:	37136 31 MILE RD
Second Line	:
City	:	RICHMOND
State	:	MI
Zip	:	48062
Country	:	US
Telephone Number	:	586-727-6750
Fax Number	:	586-727-6752

Provider Business Practice Location Address
First Line	:	37136 31 MILE RD
Second Line	:
City	:	RICHMOND
State	:	MI
Zip	:	48062
Country	:	US
Telephone Number	:	586-727-6750
Fax Number	:	586-727-6752

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

Provider Enumeration Date	:	11/07/2005
Last Update Date	:	04/01/2009

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