Provider Demographics
NPI:1275623365
Name:HELLER, STEPHEN F (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:F
Last Name:HELLER
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:35 DANBURY RD
Mailing Address - Street 2:UNIT 5 WILTON MEDICAL WALK IN CLINIC INC
Mailing Address - City:WILTON
Mailing Address - State:CT
Mailing Address - Zip Code:06897
Mailing Address - Country:US
Mailing Address - Phone:203-834-8885
Mailing Address - Fax:203-834-8889
Practice Address - Street 1:35 DANBURY RD
Practice Address - Street 2:UNIT 5 WILTON MEDICAL WALK IN CLINIC INC
Practice Address - City:WILTON
Practice Address - State:CT
Practice Address - Zip Code:06897
Practice Address - Country:US
Practice Address - Phone:203-834-8885
Practice Address - Fax:203-834-8889
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT032271207R00000X
CT015149207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
2V6049OtherHEALTHNET
010015149CT02OtherBCBS
E00151Medicare UPIN