Individual
DR. DOUGLAS EDWIN HERITAGE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.09
Contact information
Practice address
2026A OPITZ BLVD, WOODBRIDGE, VA 22191-3306
(703) 491-7155
(703) 690-3958
Mailing address
2026A OPITZ BLVD, WOODBRIDGE, VA 22191-3306
(703) 491-7155
(703) 690-3958
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
0101027756
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101027756
MEDICAL LICENSE
VA
05
—
6276032
—
VA
Enumeration date
04/17/2006
Last updated
03/07/2023
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