Provider Demographics
NPI:1265439954
Name:HEAPE, DAVID E (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:E
Last Name:HEAPE
Suffix:
Gender:M
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:PO BOX 11407
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35246-0100
Mailing Address - Country:US
Mailing Address - Phone:888-313-5258
Mailing Address - Fax:205-313-5298
Practice Address - Street 1:298 MEMORAL DRIVE
Practice Address - Street 2:OCONEE MEMORIAL HOSPITAL
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29672
Practice Address - Country:US
Practice Address - Phone:888-313-5258
Practice Address - Fax:205-313-5298
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC32170207P00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCG34360OtherSOUTH CAROLINA MEDICAID #
FL27499OtherBCBSF GRP# 98513
FL253093700Medicaid
FL606478700OtherDOL GRP#
SCG34360Medicaid
SC32170OtherSOUTH CAROLINA MEDICAL LICENSE
SC32170OtherSOUTH CAROLINA MEDICAL LICENSE
FL27499OtherBCBSF GRP# 98513