Provider Demographics
NPI:1568531176
Name:HEIM, STEVEN W
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:W
Last Name:HEIM
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9007
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22906-9007
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2871 ROCKFISH VALLEY HWY
Practice Address - Street 2:
Practice Address - City:NELLYSFORD
Practice Address - State:VA
Practice Address - Zip Code:22958
Practice Address - Country:US
Practice Address - Phone:434-297-6000
Practice Address - Fax:434-297-6550
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101222035207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA005641799Medicaid
VA080007113Medicare PIN
VAG21775Medicare UPIN