Provider Demographics
NPI:1508967514
Name:HEIDI J LITTMAN MD INC
Entity Type:Organization
Organization Name:HEIDI J LITTMAN MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:J
Authorized Official - Last Name:LITTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-686-0022
Mailing Address - Street 1:24700 LORAIN RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:NORTH OLMSTED
Mailing Address - State:OH
Mailing Address - Zip Code:44070-2088
Mailing Address - Country:US
Mailing Address - Phone:440-686-0022
Mailing Address - Fax:440-686-0025
Practice Address - Street 1:24700 LORAIN RD
Practice Address - Street 2:SUITE 201
Practice Address - City:NORTH OLMSTED
Practice Address - State:OH
Practice Address - Zip Code:44070-2088
Practice Address - Country:US
Practice Address - Phone:440-686-0022
Practice Address - Fax:440-686-0025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2012-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35065746208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2718554Medicaid
OH1841291069OtherINDIVIDUAL NPI