Provider Demographics
NPI:1710336318
Name:HEIDI A HEAP-CHESTER MD LLC
Entity Type:Organization
Organization Name:HEIDI A HEAP-CHESTER MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:HEAP-CHESTER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:207-844-3170
Mailing Address - Street 1:PO BOX 113
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011-0113
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:222 AUBURN ST
Practice Address - Street 2:SUITE 102
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04103-6002
Practice Address - Country:US
Practice Address - Phone:207-699-3830
Practice Address - Fax:207-699-3831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-06
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty