Provider Demographics
NPI:1770533051
Name:HEANEY, STEVEN J (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:J
Last Name:HEANEY
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 1:201 ARCH STREET
Mailing Address - Street 2:FIRST FLOOR
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335
Mailing Address - Country:US
Mailing Address - Phone:814-724-3201
Mailing Address - Fax:814-724-3204
Practice Address - Street 1:201 ARCH STREET
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335
Practice Address - Country:US
Practice Address - Phone:814-724-3201
Practice Address - Fax:814-724-3204
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD031283E208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA208830OtherUPMC PROVIDER NUMBER
PAP-66290045OtherMULTIPLAN PROVIDER NUMBER
PA0010873570002Medicaid
PA707142OtherBLUE SHIELD PROVIDER NUMB
PA251595420002OtherTRICARE PROVIDER NUMBER
PA0010873570002Medicaid
PAP-66290045OtherMULTIPLAN PROVIDER NUMBER
PA707142OtherBLUE SHIELD PROVIDER NUMB