Individual
DR. PETER WILLIAM HEETDERKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3024 NEW BERN AVE, RALEIGH, NC 27610-1247
(919) 350-7270
(919) 350-7204
Mailing address
2920 HIGHWOODS BLVD, RALEIGH, NC 27604-0010
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2005-01601
NC
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
2005-01601
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5902133
—
NC
Enumeration date
07/12/2006
Last updated
02/25/2021
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