Individual
DR. GLEN HEISE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2 S 21ST ST, HARRISBURG, PA 17104-1314
(717) 238-1513
Mailing address
2 S 21ST ST, HARRISBURG, PA 17104-1314
(717) 238-1513
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD029515E
PA
Other
Enumeration date
08/25/2005
Last updated
07/08/2007
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