Individual
MARK ROBERT HEITZMAN
Active
Individual
MARK ROBERT HEITZMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
042.0006618
VT
207RI0011X
Interventional Cardiology Physician
420006618
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005341
—
VT
01
—
060014973
RAIL ROAD MEDICARE
VT
01
—
P01125405
RAILROAD MEDICARE LINKED TO CVMC MGP
VT
Enumeration date
07/19/2006
Last updated
12/04/2014
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