Individual
MR. CRAIG D HEINER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
240 EAST MAIN, REXBURG, ID 83440
(208) 356-8808
(208) 356-8810
Mailing address
240 EAST MAIN, REXBURG, ID 83440
(208) 356-8808
(208) 356-8810
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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