Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 205118 | MA |
N | 111NI0900X | Internist | 205118 | MA |
Y | 207RC0000X | Internist - Cardiovascular Disease | 205118 | MA |
N | 207RC0001X | Clinical Cardiac Electrophysiologist | 205118 | MA |
NPI | 1255313334 |
---|---|
Provider Name | Dr. Edwin Kevin Heist |
First Address | Charlestown, MA 02129-9142 |
Second Address | Boston, MA 02114-2696 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/11/2005 |
Last Update Date | 10/06/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2041961 | (05) | MA |
466508 | TUFTS HEALTH PLAN (01) | MA |
I09485 | (02) | |
J27293 | BCBS MA (01) | MA |