Provider Demographics
NPI:1922337591
Name:OPPERMAN, HEIDEMARIE I (PA-C)
Entity Type:Individual
Prefix:
First Name:HEIDEMARIE
Middle Name:I
Last Name:OPPERMAN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 MEDICAL CENTER BLVD
Mailing Address - Street 2:CROZER MEDICAL CENTER TRAUMA SUITE 440
Mailing Address - City:CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19013-3902
Mailing Address - Country:US
Mailing Address - Phone:610-447-6695
Mailing Address - Fax:610-447-6088
Practice Address - Street 1:1 MEDICAL CENTER BLVD
Practice Address - Street 2:CROZER MEDICAL CENTER TRAUMA SUITE 440
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-3902
Practice Address - Country:US
Practice Address - Phone:610-447-6695
Practice Address - Fax:610-447-6088
Is Sole Proprietor?:No
Enumeration Date:2009-12-10
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMA054145363A00000X
PAOA002408363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant