Provider Demographics
NPI:1962465674
Name:SYROPOULOS, HEIDI J (MD)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:J
Last Name:SYROPOULOS
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 1:1010 W LEHIGH AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19133-1640
Mailing Address - Country:US
Mailing Address - Phone:267-273-7000
Mailing Address - Fax:267-273-7056
Practice Address - Street 1:1010 W LEHIGH AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19133-1640
Practice Address - Country:US
Practice Address - Phone:267-273-7000
Practice Address - Fax:267-273-7056
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD042138E207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0114500201OtherAMERICHOICE
PA5754595OtherCIGNA
PA1962465674OtherHEALTH PARTNERS
PA2147449000OtherKEYSTONE HEALTH PLAN EAST
1462781OtherHIGHMARK BS
2147449000OtherKEYSTONE
PA7716393OtherAETNA
04-45816OtherEVERCARE
PA1462781OtherBLUE SHIELD
PA0011450020004Medicaid
2147449002OtherBCBS HIGHMARK KEYSTONE
PA17267OtherBRAVO ELDER HEALTH
PA30040715OtherKEYSTONE MERCY HEALTH PLAN
PA7716393OtherAETNA
PA5754595OtherCIGNA
PA30040715OtherKEYSTONE MERCY HEALTH PLAN
PA0011450020004Medicaid