Provider Demographics
NPI:1962499582
Name:HEUSINKVELD, DAVID CHARLES (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:CHARLES
Last Name:HEUSINKVELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 504556
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63150-0001
Mailing Address - Country:US
Mailing Address - Phone:615-297-6006
Mailing Address - Fax:615-298-6778
Practice Address - Street 1:4230 HARDING PIKE
Practice Address - Street 2:STE. 530 HEART INSTITUTE
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2013
Practice Address - Country:US
Practice Address - Phone:615-297-6006
Practice Address - Fax:615-298-6778
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN24306207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN38557751Medicaid
TN4161326OtherBLUE CROSS BLUE SHIELD
TN4621087OtherAETNA
TNP00466144OtherRAILROAD MEDICARE
TNP00466144OtherRAILROAD MEDICARE
TN38557751Medicare PIN