Individual
DR. EDWIN KEVIN HEIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD PHD
Contact information
Practice address
55 FRUIT ST, GRB 109 CARDIAC UNIT ASSOCIATES, BOSTON, MA 02114-2696
(617) 726-8514
(617) 726-7519
Mailing address
PO BOX 9142, MASS GENERAL PHYSICIAN ORGANIZATION, CHARLESTOWN, MA 02129-9142
(617) 726-4959
(617) 726-3852
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
205118
MA
207RC0000X
Cardiovascular Disease Physician
Primary
205118
MA
207RC0001X
Clinical Cardiac Electrophysiology Physician
205118
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2041961
—
MA
01
—
466508
TUFTS HEALTH PLAN
MA
01
—
J27293
BCBS MA
MA
Enumeration date
11/15/2005
Last updated
06/10/2013
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