Provider Demographics
NPI:1245397306
Name:HEINRICHS, DOUGLAS WAYNE (MD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:WAYNE
Last Name:HEINRICHS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:5034 DORSEY HALL DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-7719
Mailing Address - Country:US
Mailing Address - Phone:410-964-6486
Mailing Address - Fax:410-964-6486
Practice Address - Street 1:5034 DORSEY HALL DR
Practice Address - Street 2:SUITE 103
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-7719
Practice Address - Country:US
Practice Address - Phone:410-964-6486
Practice Address - Fax:410-964-6486
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-01
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MDD222792084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry