Individual
MR. CRAIG D HEINER
Active
Individual
MR. CRAIG D HEINER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M4318
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010003449
BLUE SHIELD OF IDAHO
ID
05
—
0027111
—
ID
01
—
DW417
BLUE CROSS OF IDAHO
ID
Enumeration date
10/19/2006
Last updated
02/22/2010
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