Provider Demographics
NPI:1871619551
Name:HEYM, HERBERT H (MD)
Entity type:Individual
Prefix:DR
First Name:HERBERT
Middle Name:H
Last Name:HEYM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1711 WOODLAWN AVE
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19806-2455
Mailing Address - Country:US
Mailing Address - Phone:302-654-9511
Mailing Address - Fax:
Practice Address - Street 1:1711 WOODLAWN AVE
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19806-2455
Practice Address - Country:US
Practice Address - Phone:302-654-9511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10000563207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000074202Medicaid
DE121060Medicare ID - Type Unspecified
DEB66458Medicare UPIN