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Individual

HEBER J DE OLIVEIRA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CSA

Contact information

Practice address
14103 CORUNNA CT, LAUREL, MD 20707-6901
(301) 531-4554
Mailing address
14103 CORUNNA CT, LAUREL, MD 20707-6901
(301) 531-4554

Taxonomy

Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
363AS0400X
Surgical Physician Assistant
Primary
SA0117
DC

Other

Enumeration date
12/28/2011
Last updated
01/13/2017
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