Individual
DR. GREGORY L HEACOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2002 MEDICAL PARKWAY, SUITE 230, ANNAPOLIS, MD 21401-3282
(410) 266-3900
(410) 266-9245
Mailing address
2002 MEDICAL PARKWAY, SUITE 230, ANNAPOLIS, MD 21401-3282
(410) 266-3900
(410) 266-9245
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
D0055675
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
607361100
—
MD
Enumeration date
02/16/2007
Last updated
09/15/2016
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