Individual
ROBERT ALLEN JAMES HEIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1210 W FARIS RD, GREENVILLE, SC 29605-4444
(864) 522-1800
(864) 522-1806
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8603
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
LL39475
SC
207R00000X
Internal Medicine Physician
LL39475
SC
2085N0700X
Neuroradiology Physician
Primary
39475
SC
2085R0202X
Diagnostic Radiology Physician
LL39475
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
SC
Enumeration date
05/26/2016
Last updated
07/13/2022
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