Provider Demographics
NPI:1558552810
Name:LUIS A HEFFESS, MD, PC
Entity Type:Organization
Organization Name:LUIS A HEFFESS, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LUIS
Authorized Official - Middle Name:ALBERTO
Authorized Official - Last Name:HEFFESS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-526-2090
Mailing Address - Street 1:1160 VARNUM ST NE
Mailing Address - Street 2:SUITE # 112
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-2107
Mailing Address - Country:US
Mailing Address - Phone:202-526-2090
Mailing Address - Fax:202-529-4516
Practice Address - Street 1:1160 VARNUM ST NE
Practice Address - Street 2:SUITE # 112
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-2107
Practice Address - Country:US
Practice Address - Phone:202-526-2090
Practice Address - Fax:202-529-4516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-01
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD8600207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
443798Medicare PIN
DCB94122Medicare UPIN