Provider Demographics
NPI:1548423940
Name:HECKER, SUSAN MICHELLE (MD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:MICHELLE
Last Name:HECKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:252 S 4TH ST
Mailing Address - Street 2:FL 2
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-6111
Mailing Address - Country:US
Mailing Address - Phone:717-270-3751
Mailing Address - Fax:
Practice Address - Street 1:1802 YAKIMA AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-4499
Practice Address - Country:US
Practice Address - Phone:253-272-7777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-07
Last Update Date:2021-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD469156208G00000X
MDD89701208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty