Provider Demographics
NPI:1881759124
Name:HEINS, CYNTHIA L (MD)
Entity type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:L
Last Name:HEINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1501 SAN PEDRO SEDR
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87108-5153
Mailing Address - Country:US
Mailing Address - Phone:505-265-1711
Mailing Address - Fax:505-255-6416
Practice Address - Street 1:14139 POTOMAC MILLS ROAD
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-4644
Practice Address - Country:US
Practice Address - Phone:703-490-8400
Practice Address - Fax:703-490-7635
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2015-12-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA031439207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
002374K32Medicare ID - Type Unspecified
H91766Medicare UPIN