Provider Demographics
NPI:1538117825
Name:HEIM, JOHN A (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:A
Last Name:HEIM
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:P. O. BOX 8500 - 6300
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-0001
Mailing Address - Country:US
Mailing Address - Phone:215-807-8000
Mailing Address - Fax:215-807-8235
Practice Address - Street 1:3998 RED LION RD
Practice Address - Street 2:SUITE 214
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19114-1436
Practice Address - Country:US
Practice Address - Phone:215-612-5050
Practice Address - Fax:215-612-5214
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD423045208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001594107-04OtherAMERICHOICE
PA0015941070004Medicaid
PA4292737OtherAETNA PPO
PA1242002OtherUNITED HEALTHCARE
PA1541951OtherHIGHMARK BLUE SHIELD
PA3416852OtherAETNA HMO
PA34517OtherHEALTH PARTNERS
PAP00070913OtherRAILROAD MEDICARE
PA1541951OtherPERSONAL CHOICE
PA0015941070003Medicaid
PA30009246OtherKEYSTONE MERCY
PA20045126OtherAMERIHEALTH MERCY
PA2226177000OtherIBC, KEYSTONE
PA0015941070005Medicaid
PA1801870OtherCIGNA
PA30009246OtherKEYSTONE MERCY
PA1801870OtherCIGNA