Provider Demographics
NPI:1396305140
Name:HEINEMAN, KATRIN (DPM)
Entity type:Individual
Prefix:DR
First Name:KATRIN
Middle Name:
Last Name:HEINEMAN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2106 SILVERSIDE RD STE 201
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-4164
Mailing Address - Country:US
Mailing Address - Phone:302-478-8099
Mailing Address - Fax:302-478-8717
Practice Address - Street 1:2106 SILVERSIDE RD STE 201
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-4164
Practice Address - Country:US
Practice Address - Phone:302-478-8099
Practice Address - Fax:302-478-8717
Is Sole Proprietor?:No
Enumeration Date:2019-06-14
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEE1-0010278213E00000X, 213ES0131X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery