Provider Demographics
NPI:1891940557
Name:NEWKIRK, HEIDI REBECCA (DPM)
Entity Type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:REBECCA
Last Name:NEWKIRK
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 PLAZA DR
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-1470
Mailing Address - Country:US
Mailing Address - Phone:336-768-8848
Mailing Address - Fax:
Practice Address - Street 1:1410 PLAZA DR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-1470
Practice Address - Country:US
Practice Address - Phone:336-768-8848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-11-22
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR64964213E00000X
NH0334213ES0103X
NC836213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1025592Medicaid