Provider Demographics
NPI:1003813437
Name:DONATO, HEATHER O (MD)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:O
Last Name:DONATO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7205 WOLF RIVER BLVD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:GERMANTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38138-1758
Mailing Address - Country:US
Mailing Address - Phone:901-752-4500
Mailing Address - Fax:901-752-4328
Practice Address - Street 1:7205 WOLF RIVER BLVD
Practice Address - Street 2:SUITE 150
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138-1758
Practice Address - Country:US
Practice Address - Phone:901-752-4500
Practice Address - Fax:901-752-4328
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN30428207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3852211Medicaid
9597876OtherCIGNA
TN4076399OtherBCBS
7740326OtherAETNA
9597876OtherCIGNA
7740326OtherAETNA
TNH15698Medicare UPIN