Provider Demographics
NPI:1952615775
Name:MIDDENDORF, HEIDI E (MD)
Entity Type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:E
Last Name:MIDDENDORF
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:701 MORREENE RD
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-2928
Mailing Address - Country:US
Mailing Address - Phone:919-383-0426
Mailing Address - Fax:919-383-0619
Practice Address - Street 1:701 MORREENE RD
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27705-2928
Practice Address - Country:US
Practice Address - Phone:919-383-0426
Practice Address - Fax:919-383-0619
Is Sole Proprietor?:No
Enumeration Date:2010-08-04
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC390352084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry