Provider Demographics
NPI:1407859010
Name:HEIS, STEPHEN D (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:D
Last Name:HEIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8000 FIVE MILE RD
Mailing Address - Street 2:STE 340
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45230-2192
Mailing Address - Country:US
Mailing Address - Phone:513-232-8800
Mailing Address - Fax:513-232-8802
Practice Address - Street 1:8000 FIVE MILE RD
Practice Address - Street 2:STE 340
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45230-2192
Practice Address - Country:US
Practice Address - Phone:513-232-8800
Practice Address - Fax:513-232-8802
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH46583208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0518783Medicaid
OH0518783Medicaid
OHHE0530003Medicare PIN