Provider Demographics
NPI:1093923765
Name:GREER, HEATHER O (MD)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:O
Last Name:GREER
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 1:150 MARKET RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:DALEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24083-3258
Mailing Address - Country:US
Mailing Address - Phone:540-996-0460
Mailing Address - Fax:
Practice Address - Street 1:150 MARKET RIDGE LN
Practice Address - Street 2:
Practice Address - City:DALEVILLE
Practice Address - State:VA
Practice Address - Zip Code:24083-3258
Practice Address - Country:US
Practice Address - Phone:540-996-0460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-18
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL27799207VM0101X
390200000X
VA0101254910207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51598200OtherBLUE CROSS
AL051106542OtherBLUE CROSS
AL51598201OtherBLUE CROSS
ALP00821413OtherRAILROAD MEDICARE
AL110008Medicaid
MS01952891Medicaid
AL110009Medicaid
AL119040Medicaid
AL51598201OtherBLUE CROSS