Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 0101057111 | VA |
NPI | 1013943976 |
---|---|
Provider Name | Dr. Andrew Jared Heller |
First Address | Richmond, VA 23298-0146 |
Second Address | Richmond, VA 23219-2050 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H18945 | (02) | VA |