Individual
DR. CYNTHIA LEE HECKMAN-DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
601 N. MICHIGAN ST., LAKEVILLE, IN 46536
(574) 784-8244
(574) 784-8632
Mailing address
710 N NILES AVE, SOUTH BEND, IN 46617-1924
(574) 647-1610
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01033081A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000085185
BCBS BMG LAKEVILLE
IN
01
—
000000391881
BCBS BMG IRELAND
IN
01
—
080018191
RR MEDICARE
IN
05
—
100089660
—
IN
Enumeration date
12/16/2005
Last updated
03/17/2016
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