Provider Demographics
NPI:1235216508
Name:HEATH, DENEEN M (MD)
Entity Type:Individual
Prefix:
First Name:DENEEN
Middle Name:M
Last Name:HEATH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 37174
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21297-3174
Mailing Address - Country:US
Mailing Address - Phone:571-423-5699
Mailing Address - Fax:571-423-5698
Practice Address - Street 1:8260 WILLOW OAKS CORPORATE DR STE 400
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4513
Practice Address - Country:US
Practice Address - Phone:703-573-0504
Practice Address - Fax:703-573-4856
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2022-04-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD551382080P0202X
DCMD322822080P0202X
VA01018405352080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H56367Medicare UPIN