Individual
DR. MAGEN ELIZABETH HEIDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
50 CROSS PARK CT, GREENVILLE, SC 29605-4263
(864) 797-7035
(864) 797-7040
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(803) 434-1335
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
52472
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
524720
—
SC
Enumeration date
03/21/2018
Last updated
06/21/2023
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