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Individual

PAUL P HEIDEMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
252 MCHENRY ST, BURLINGTON, WI 53105
(262) 767-6100
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
63817
WI
2085R0204X
Vascular & Interventional Radiology Physician
Primary
63817
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1144546870
WI
05
ENROLLED
IA
05
ENROLLED
MN
05
ENROLLED
WI
Enumeration date
04/20/2010
Last updated
07/29/2025
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