Provider Demographics
NPI:1598780363
Name:HEIN, KATHERINE D (MD)
Entity Type:Individual
Prefix:
First Name:KATHERINE
Middle Name:D
Last Name:HEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:D
Other - Last Name:HEIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:117 W CENTRAL STREET
Mailing Address - Street 2:SUITE 203
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-4383
Mailing Address - Country:US
Mailing Address - Phone:508-875-7777
Mailing Address - Fax:508-875-8777
Practice Address - Street 1:117 W CENTRAL STREET
Practice Address - Street 2:SUITE 203
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-4383
Practice Address - Country:US
Practice Address - Phone:508-875-7777
Practice Address - Fax:508-875-8777
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA791982086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAA3072101OtherMEDICARE PTAN
MA079198OtherTUFTS
MAJ21902OtherBCBS
H11291Medicare UPIN
MA079198OtherTUFTS