Provider Demographics
NPI:1437206430
Name:SONDRA DK HEILIGMAN MD
Entity Type:Organization
Organization Name:SONDRA DK HEILIGMAN MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SONDRA
Authorized Official - Middle Name:DK
Authorized Official - Last Name:HEILIGMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-318-8550
Mailing Address - Street 1:7211 PARK HEIGHTS AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-5403
Mailing Address - Country:US
Mailing Address - Phone:410-318-8550
Mailing Address - Fax:
Practice Address - Street 1:7211 PARK HEIGHTS AVE
Practice Address - Street 2:SUITE B
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21208-5403
Practice Address - Country:US
Practice Address - Phone:410-318-8550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD37281208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDE60650Medicare UPIN