Provider Demographics
NPI:1568605459
Name:HEIZMAN, DAWN C (MD)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:C
Last Name:HEIZMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:C
Other - Last Name:CHARLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2790 CLAY EDWARDS DRIVE, SUITE 530
Mailing Address - Street 2:MERITAS HEALTH CORPORATION D/B/A MERITAS HEALTH PAVIOLI
Mailing Address - City:NORTH KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116
Mailing Address - Country:US
Mailing Address - Phone:816-452-3300
Mailing Address - Fax:816-453-0677
Practice Address - Street 1:2790 CLAY EDWARDS DRIVE, SUITE 530
Practice Address - Street 2:MERITAS HEALTH PAVILION FOR WOMEN
Practice Address - City:NORTH KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-2792
Practice Address - Country:US
Practice Address - Phone:816-452-3300
Practice Address - Fax:816-453-0677
Is Sole Proprietor?:No
Enumeration Date:2009-04-08
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MO2013027451207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program