Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 29997 | SC |
NPI | 1013113893 |
---|---|
Provider Name | Dr. Robert J Heineck |
First Address | Georgetown, SC 29442-4203 |
Second Address | Myrtle Beach, SC 29588 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2007 |
Last Update Date | 16/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
299974 | (05) | SC |