Heffernan, Robert

Heffernan, Robert is an individual health care provider with primary practice located at 4212 Ne Broadway St , Portland OR 97213-1460. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Heffernan, Robert can be contacted via phone (503) 249-8787.

Contact Information

Primary practice address
4212 Ne Broadway St Portland OR 97213-1460
Phone: (503) 249-8787
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD 10995 Oregon

Profile Details

NPI number 1518034917
LBN Legal business name Heffernan, Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 29th, 2006
Last updated Oct 28th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518034917 NPPES
Oregon MEDICAID 23305-6

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