Provider Demographics
NPI:1275527145
Name:HEIL, DAWN MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:DAWN
Middle Name:MARIE
Last Name:HEIL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:571 SAINT JOSEPHS BLVD FL 2
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901-3230
Mailing Address - Country:US
Mailing Address - Phone:607-271-2050
Mailing Address - Fax:607-873-1244
Practice Address - Street 1:445 E WATER ST
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901-3410
Practice Address - Country:US
Practice Address - Phone:607-734-2067
Practice Address - Fax:607-732-1349
Is Sole Proprietor?:No
Enumeration Date:2005-09-07
Last Update Date:2020-11-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY201319208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01613441Medicaid
NY01613441Medicaid
NY34784GMedicare ID - Type Unspecified