Provider Demographics
NPI:1164627667
Name:BEERY, HEIDI MARGARET (MD)
Entity Type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:MARGARET
Last Name:BEERY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2508 NW MEDICAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97471-5510
Mailing Address - Country:US
Mailing Address - Phone:541-673-5225
Mailing Address - Fax:541-229-4777
Practice Address - Street 1:2508 NW MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97471-5510
Practice Address - Country:US
Practice Address - Phone:541-673-5225
Practice Address - Fax:541-229-4777
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD29209207R00000X, 208M00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR168395Medicaid
381896Medicare Oscar/Certification