Individual
MICHAEL A HETER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
217 GLENSFORD DR, FAYETTEVILLE, NC 28314
(910) 213-3053
Mailing address
1416 PARKVIEW CIR UNIT 205, WILMINGTON, NC 28405-4314
(910) 262-2898
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35661
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
42028
BLUE CROSS/BLUE SHEILD
NC
05
—
8942028
—
NC
Enumeration date
09/06/2006
Last updated
11/22/2019
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