Provider Demographics
NPI:1922159516
Name:HEISS, JOHN DAVID (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:DAVID
Last Name:HEISS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:10 CENTER DRIVE
Mailing Address - Street 2:RM 5D37
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20854-1414
Mailing Address - Country:US
Mailing Address - Phone:301-496-2921
Mailing Address - Fax:301-402-0380
Practice Address - Street 1:10 CENTER DRIVE
Practice Address - Street 2:RM 5D37
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20854-1414
Practice Address - Country:US
Practice Address - Phone:301-496-2921
Practice Address - Fax:301-402-0380
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MDD0055110207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery