Provider Demographics
NPI:1396726469
Name:HEINZ, STEVEN WALTER (DC)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:WALTER
Last Name:HEINZ
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37136 31 MILE RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:MI
Mailing Address - Zip Code:48062
Mailing Address - Country:US
Mailing Address - Phone:586-727-6750
Mailing Address - Fax:586-727-6752
Practice Address - Street 1:37136 31 MILE RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:MI
Practice Address - Zip Code:48062
Practice Address - Country:US
Practice Address - Phone:586-727-6750
Practice Address - Fax:586-727-6752
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-07
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301005737111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0E052290OtherBCBS
MI950E052290OtherBCBSM
MIMI1412Medicare PIN
MI950E052290OtherBCBSM