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Individual

BRENT EDWARD HEIDEMAN JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0011
(336) 716-0424
Mailing address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0011
(336) 716-0424

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
63895
TN
207RC0000X
Cardiovascular Disease Physician
Primary
2023-00911
NC
207RP1001X
Pulmonary Disease Physician
2023-00911
NC
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/05/2017
Last updated
09/22/2023
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