Provider Demographics
NPI:1033276274
Name:HEIM, DOUGLAS BERNARD (OD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:BERNARD
Last Name:HEIM
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3450 ASHEVILLE HWY
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28791-0701
Mailing Address - Country:US
Mailing Address - Phone:828-692-2593
Mailing Address - Fax:828-693-5558
Practice Address - Street 1:3450 ASHEVILLE HWY
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791-0701
Practice Address - Country:US
Practice Address - Phone:828-692-2593
Practice Address - Fax:828-693-5558
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1070152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2270715OtherUNITED HEALTHCARE OF NC
NC09368OtherBCBS OF NC
NC7909368Medicaid
NC0689210001OtherPALMETTO GBA
NC410008039OtherRAILROAD MEDICARE
NC246389BMedicare ID - Type Unspecified
NC0689210001OtherPALMETTO GBA
NC09368OtherBCBS OF NC