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Individual

HEIDI FITE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
11293 N M 37, STE. A, BUCKLEY, MI 49620-9593
(231) 269-4185
(231) 269-4461
Mailing address
11293 N M 37, STE. A, BUCKLEY, MI 49620-9593
(231) 269-4185
(231) 269-4461

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601007246
MI
363A00000X
Physician Assistant
6274
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003121146A
GA
05
1343PA
SC
Enumeration date
10/10/2011
Last updated
10/22/2020
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