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NPI Code Detail

MEDICARE: FREDERICK A HEIDEN DO

MEDICARE:   FREDERICK A HEIDEN  DO
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
1207L00000XAnesthesiology Physician42880WI

Other Identifiers

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

General Provider Information

NPI Number : 1982603957
Entity Type Code : Individual
Provider Name (Legal Business Name) : FREDERICK A HEIDEN DO
Provider Business Mailing Address
First Line : PO BOX 735044
Second Line :
City : CHICAGO
State : IL
Zip : 60673-5044
Country : US
Telephone Number : 800-326-2250
Fax Number :
Provider Business Practice Location Address
First Line : 36500 AURORA DR
Second Line :
City : SUMMIT
State : WI
Zip : 53066-4899
Country : US
Telephone Number : 262-434-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2005
Last Update Date : 06/25/2024

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Directions to “ FREDERICK A HEIDEN DO” Practice Location

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