Individual
CLARE B HEIDTKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2810 CHARLEVOIX AVE, SUITE 104, PETOSKEY, MI 49770-8421
(231) 487-0970
(231) 487-0979
Mailing address
2810 CHARLEVOIX AVE, SUITE 104, PETOSKEY, MI 49770-8421
(231) 487-0970
(231) 487-0979
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
CH045760
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
045760
BLUE CROSS BLUE SHEILD MI
MI
05
—
3509689
—
MI
Enumeration date
10/06/2006
Last updated
07/08/2007
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