Provider Demographics
NPI:1720390511
Name:JEREB, HEATHER (MD)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:JEREB
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:BINDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:555 MIDTOWNE ST NE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-5731
Mailing Address - Country:US
Mailing Address - Phone:616-588-1200
Mailing Address - Fax:616-588-1250
Practice Address - Street 1:555 MIDTOWNE ST NE
Practice Address - Street 2:SUITE 400
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-5731
Practice Address - Country:US
Practice Address - Phone:616-588-1200
Practice Address - Fax:616-588-1250
Is Sole Proprietor?:No
Enumeration Date:2010-07-08
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301096363207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology