Provider Demographics
NPI:1982710877
Name:HEATH, ALFRED OSWALD (MD)
Entity Type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:OSWALD
Last Name:HEATH
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:PO BOX 8237
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE AMALIE
Mailing Address - State:VI
Mailing Address - Zip Code:00801-1237
Mailing Address - Country:US
Mailing Address - Phone:340-776-1273
Mailing Address - Fax:340-774-3538
Practice Address - Street 1:MEDICAL ARTS COMPLEX
Practice Address - Street 2:SUITE #2
Practice Address - City:ST. THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802
Practice Address - Country:US
Practice Address - Phone:340-774-3538
Practice Address - Fax:340-774-3538
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI69208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VIF46619Medicare UPIN