Provider Demographics
NPI:1982874350
Name:YASMIN HEATER INTERNAL MEDICINE PA
Entity Type:Organization
Organization Name:YASMIN HEATER INTERNAL MEDICINE PA
Other - Org Name:YASMIN HEATER, MD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MGR
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:G
Authorized Official - Last Name:FEAGANES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:252-459-6600
Mailing Address - Street 1:102 INDUSTRIAL DR
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27856-1793
Mailing Address - Country:US
Mailing Address - Phone:252-459-6600
Mailing Address - Fax:252-459-6700
Practice Address - Street 1:102 INDUSTRIAL DR
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:NC
Practice Address - Zip Code:27856-1793
Practice Address - Country:US
Practice Address - Phone:252-459-6600
Practice Address - Fax:252-459-6700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-03
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200000226207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1257UOtherBLUE CROSS
NC891257UMedicaid
G03460Medicare UPIN
NC1257UOtherBLUE CROSS