Individual
DR. ROBERT A. HEAVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8029 MAIN ST, COATESVILLE, IN 46121-0133
(765) 386-7301
(765) 386-2108
Mailing address
PO BOX 133, 8029 MAIN ST, COATESVILLE, IN 46121-0133
(765) 386-7301
(765) 386-2108
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01027777
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000374885
BLUE SHIELD
IN
Enumeration date
08/31/2006
Last updated
07/08/2007
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