Individual
CHAD R HEATWOLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
601 ELMWOOD AVE, ROCHESTER, NY 14642-0002
(585) 275-2559
(585) 273-1255
Mailing address
PO BOX 278984, ROCHESTER, NY 14627-8984
(585) 275-2559
(585) 273-1255
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
230605
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02740063
—
NY
01
—
MDJ059
PREFERRED CARE
—
01
—
P010230605
BLUE CHOICE
—
01
—
P020230605
BLUE SHIELD
—
Enumeration date
07/12/2006
Last updated
07/05/2023
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