Provider Demographics
NPI:1336141621
Name:HELLER, MICHAEL S (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:S
Last Name:HELLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1869
Mailing Address - Street 2:
Mailing Address - City:FLETCHER
Mailing Address - State:NC
Mailing Address - Zip Code:28732-1869
Mailing Address - Country:US
Mailing Address - Phone:828-687-5698
Mailing Address - Fax:828-650-8081
Practice Address - Street 1:20 MEDICAL PARK DR
Practice Address - Street 2:SUITE B
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803
Practice Address - Country:US
Practice Address - Phone:828-254-8232
Practice Address - Fax:828-253-4470
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC38973207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3670294OtherUHC
SCQ38973Medicaid
NC41189OtherBC/BS NC
NC830007265OtherMEDICARE RR
NCCB3766OtherMEDICARE RR
NC1336141621Medicaid
NC56-0543246OtherTAX ID
NC8941189Medicaid
NC56-2217537OtherEIN
NC2344708AMedicare PIN
NC1336141621Medicaid
NC2344708AMedicare UPIN
NCNC6000BMedicare PIN
NC830007265OtherMEDICARE RR
SCQ38973Medicaid