# HEIDRICH, MD

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124354865
- **Authorized official:** BRYAN HEIDRICH MD (RESIDENT)
- **Authorized official phone:** (206) 790-4161

## Contact information

- **Practice address:** 1601 E HIGHLAND AVE APT 1138, PHOENIX, AZ 85016-4684
- **Practice address phone:** (206) 790-4161
- **Mailing address:** 1601 E HIGHLAND AVE APT 1138, PHOENIX, AZ 85016-4684

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | R71447 | AZ | Yes |

## Other

- **Enumeration date:** 11/01/2009
- **Last updated:** 07/14/2011