Provider Demographics
NPI:1134151061
Name:HEIKES, DANA (MD, FACS)
Entity type:Individual
Prefix:DR
First Name:DANA
Middle Name:
Last Name:HEIKES
Suffix:
Gender:M
Credentials:MD, FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:247 CALHOUN ST
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29401-1306
Mailing Address - Country:US
Mailing Address - Phone:843-722-5904
Mailing Address - Fax:843-722-1564
Practice Address - Street 1:247 CALHOUN ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29401-1306
Practice Address - Country:US
Practice Address - Phone:843-722-5904
Practice Address - Fax:843-722-1564
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20611174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCC56418Medicare UPIN