Individual
DR. EDWIN HEIDELBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD PHD
Contact information
Practice address
210 E MAIN ST, SPRINGVILLE, NY 14141-1442
(716) 592-3635
(716) 592-2929
Mailing address
210 E MAIN ST, SPRINGVILLE, NY 14141-1442
(716) 592-3635
(716) 592-2929
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
190805
NY
208000000X
Pediatrics Physician
190805
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00020006701
UNIVERA
NY
01
—
0003153
GHI
NY
01
—
000523119009
BCBS
NY
01
—
0145550001
DMERC
NY
05
—
01458795
—
NY
01
—
0408931AOA
INDEPENDENT HEALTH
NY
01
—
190805
WORKERS COMP
NY
Enumeration date
11/15/2005
Last updated
03/13/2008
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