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Individual
HEIDI M LARSON
Active
Individual
HEIDI M LARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD14388
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
046529
ANTHEM
ME
05
—
3 5150000
—
ME
01
—
5904624
AETNA
ME
Enumeration date
08/21/2006
Last updated
06/11/2020
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