Provider Demographics
NPI:1801392626
Name:KREMIN, HEATHER LADAWN (DO)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:LADAWN
Last Name:KREMIN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 PORTLAND WAY S
Mailing Address - Street 2:
Mailing Address - City:GALION
Mailing Address - State:OH
Mailing Address - Zip Code:44833-2362
Mailing Address - Country:US
Mailing Address - Phone:740-961-9303
Mailing Address - Fax:
Practice Address - Street 1:270 PORTLAND WAY S
Practice Address - Street 2:
Practice Address - City:GALION
Practice Address - State:OH
Practice Address - Zip Code:44833-2362
Practice Address - Country:US
Practice Address - Phone:419-468-7613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-02
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.015137208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics