Provider Demographics
NPI:1982889853
Name:DAVID H. HELLER, MD PC
Entity Type:Organization
Organization Name:DAVID H. HELLER, MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:H
Authorized Official - Last Name:HELLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-337-1173
Mailing Address - Street 1:541 MAIN ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:WEYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02190-1868
Mailing Address - Country:US
Mailing Address - Phone:781-337-1173
Mailing Address - Fax:
Practice Address - Street 1:541 MAIN ST
Practice Address - Street 2:SUITE 104
Practice Address - City:WEYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02190-1868
Practice Address - Country:US
Practice Address - Phone:781-337-1173
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-09
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA31933207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAM12714OtherBCBS MA
MA9776613Medicaid
MA9776613Medicaid