Provider Demographics
NPI:1801864640
Name:MAPA, HELOUISE C (MD)
Entity Type:Individual
Prefix:DR
First Name:HELOUISE
Middle Name:C
Last Name:MAPA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:EAST LIVERPOOL
Mailing Address - State:OH
Mailing Address - Zip Code:43920-2901
Mailing Address - Country:US
Mailing Address - Phone:330-385-2273
Mailing Address - Fax:330-385-2890
Practice Address - Street 1:142 W 5TH ST
Practice Address - Street 2:
Practice Address - City:EAST LIVERPOOL
Practice Address - State:OH
Practice Address - Zip Code:43920-2901
Practice Address - Country:US
Practice Address - Phone:330-385-2273
Practice Address - Fax:330-385-2890
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-09
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35037187208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0253265Medicaid
OH0253265Medicaid