Provider Demographics
NPI:1568462869
Name:SCIMECA, HEATHER PASTOR (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:PASTOR
Last Name:SCIMECA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DUMC 3135
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710-0001
Mailing Address - Country:US
Mailing Address - Phone:919-385-3376
Mailing Address - Fax:919-684-6505
Practice Address - Street 1:40 DUKE MEDICINE CIR # 3K
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-3416
Practice Address - Country:US
Practice Address - Phone:919-385-3376
Practice Address - Fax:919-684-6505
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA19734363A00000X
NC0010-09266363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1455750Medicaid
LA1455750Medicaid
LAQ23787Medicare UPIN
LA5C822P838Medicare PIN