Provider Demographics
NPI:1396721718
Name:HEATER WILLIAMSON, YASMIN (MD)
Entity type:Individual
Prefix:DR
First Name:YASMIN
Middle Name:
Last Name:HEATER WILLIAMSON
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 1:804 ENGLISH RD STE 100
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-6027
Mailing Address - Country:US
Mailing Address - Phone:252-443-3133
Mailing Address - Fax:252-443-6726
Practice Address - Street 1:804 ENGLISH RD STE 100
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-6027
Practice Address - Country:US
Practice Address - Phone:252-443-3133
Practice Address - Fax:252-443-6726
Is Sole Proprietor?:No
Enumeration Date:2005-12-17
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200000226207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC17710OtherBLUE CROSS BLUE SHIELD
NC5819635OtherAETNA
NC1396721718Medicaid
NCP01285588OtherMEDICARE RAILROAD
NCP01285588OtherMEDICARE RAILROAD
NCNC0866DMedicare PIN
NC2331670Medicare ID - Type Unspecified
NC1257UOtherBCBS
NC2048706004OtherCIGNA