Provider Demographics
NPI:1659356574
Name:GINTER, HEIDI (MD)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:
Last Name:GINTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HEIDI
Other - Middle Name:B
Other - Last Name:GINTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:125 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01085-3464
Mailing Address - Country:US
Mailing Address - Phone:413-568-6600
Mailing Address - Fax:
Practice Address - Street 1:125 N ELM ST
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:MA
Practice Address - Zip Code:01085-3464
Practice Address - Country:US
Practice Address - Phone:413-568-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA159349207Q00000X, 207QA0401X
CT52615207QA0401X
MEMD19870207QA0401X
NH16460207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1306421Medicaid
MA1308785Medicaid
MA1301071Medicaid
MA1306421Medicaid
MA1308785Medicaid
MA1301071Medicaid