Provider Demographics
NPI:1962839266
Name:HEIDEMA, ANDRIES GEERT (PHD)
Entity Type:Individual
Prefix:
First Name:ANDRIES GEERT
Middle Name:
Last Name:HEIDEMA
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 SUMNER AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01108-2315
Mailing Address - Country:US
Mailing Address - Phone:413-732-4800
Mailing Address - Fax:413-739-4239
Practice Address - Street 1:80 SUMNER AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01108-2315
Practice Address - Country:US
Practice Address - Phone:413-732-4800
Practice Address - Fax:413-739-4239
Is Sole Proprietor?:No
Enumeration Date:2013-10-01
Last Update Date:2013-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist