MEDICARE: HEIDI A HEAP-CHESTER MD LLC

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	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1710336318
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEIDI A HEAP-CHESTER MD LLC

Provider Business Mailing Address
First Line	:	PO BOX 113
Second Line	:
City	:	BRUNSWICK
State	:	ME
Zip	:	04011-0113
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	15 SKY VIEW DR
Second Line	:
City	:	CUMBERLAND FORESIDE
State	:	ME
Zip	:	04110-1472
Country	:	US
Telephone Number	:	207-699-3830
Fax Number	:	207-699-3831

Authorized Official
Title or Position	:	OWNER
Name	:	DR. HEIDI ANNE HEAP-CHESTER
Credential	:	M.D.
Telephone Number	:	207-844-3170

Provider Enumeration Date	:	06/06/2016
Last Update Date	:	06/17/2024

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