Provider Demographics
NPI:1831214451
Name:HEIN, MARTHA ATKINSON (COTAL)
Entity type:Individual
Prefix:MRS
First Name:MARTHA
Middle Name:ATKINSON
Last Name:HEIN
Suffix:
Gender:F
Credentials:COTAL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2325 STONEHEDGE DR
Mailing Address - Street 2:
Mailing Address - City:MATTHEWS
Mailing Address - State:NC
Mailing Address - Zip Code:28104-6717
Mailing Address - Country:US
Mailing Address - Phone:704-321-7900
Mailing Address - Fax:
Practice Address - Street 1:7003 WALLACE ROAD
Practice Address - Street 2:SUITE 100
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28212
Practice Address - Country:US
Practice Address - Phone:704-568-5510
Practice Address - Fax:704-568-0453
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC078174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist