Provider Demographics
NPI:1487680997
Name:HERBERT H HEYM M.D. P.A.
Entity Type:Organization
Organization Name:HERBERT H HEYM M.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HERBERT
Authorized Official - Middle Name:H
Authorized Official - Last Name:HEYM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-654-9511
Mailing Address - Street 1:1711 WOODLAWN AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19806-2455
Mailing Address - Country:US
Mailing Address - Phone:302-654-9511
Mailing Address - Fax:302-656-8993
Practice Address - Street 1:1711 WOODLAWN AVE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19806-2455
Practice Address - Country:US
Practice Address - Phone:302-654-9511
Practice Address - Fax:302-656-8993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10000563207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000074202Medicaid
DE121060Medicare ID - Type Unspecified
DE0000074202Medicaid