Individual
TODD E HEATON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
417 STATE ST., SUITE 305, WEBBER EAST, BANGOR, ME 04401
(120) 797-3995
(207) 973-9003
Mailing address
43 WHITING HILL RD STE 300, BREWER, ME 04412-1006
(207) 973-5000
(207) 973-5042
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
MD428905
MI
2086S0120X
Pediatric Surgery Physician
Primary
MD428905
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD24997
STATE MEDICAL BOARD
ME
Enumeration date
08/29/2007
Last updated
03/28/2022
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