Provider Demographics
NPI:1114926623
Name:HEEGER, STEPHEN C (DO)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:C
Last Name:HEEGER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 SOUTHFIELD DR
Mailing Address - Street 2:SUITE 1140
Mailing Address - City:PLAINFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46168-4498
Mailing Address - Country:US
Mailing Address - Phone:317-839-7200
Mailing Address - Fax:317-837-7926
Practice Address - Street 1:1100 SOUTHFIELD DR
Practice Address - Street 2:SUITE 1140
Practice Address - City:PLAINFIELD
Practice Address - State:IN
Practice Address - Zip Code:46168-4498
Practice Address - Country:US
Practice Address - Phone:317-839-7200
Practice Address - Fax:317-837-7926
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN2000977207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200350650Medicaid
IN200350650Medicaid
IN343800GMedicare ID - Type Unspecified