Heuckeroth, Robert O
Heuckeroth, Robert O is an individual health care provider with primary practice located at 3401 Civic Center Blvd Children'S Hospital Of Philadelphia - Gastroenterology, Philadelphia PA 19104-4319. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Gastroenterology, which is considered as his primary health care specialty. Heuckeroth, Robert O can be contacted via phone (215) 590-3247.Contact Information
Primary practice address
3401 Civic Center Blvd Children'S Hospital Of Philadelphia - Gastroenterology
Philadelphia PA 19104-4319
Phone: (215) 590-3247
Fax: (215) 590-3606
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Gastroenterology | 2080P0206X | 104739 | Missouri |
| Allopathic & Osteopathic Physicians / Pediatric Gastroenterology | 2080P0206X | MD449684 | Pennsylvania |
Profile Details
| NPI number | 1659398188 |
|---|---|
| LBN Legal business name | Heuckeroth, Robert O |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 17th, 2006 |
| Last updated | Oct 21st, 2014 - about 11 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1659398188 | NPPES |
| Mississippi | MEDICAID | 126902 | |
| Mississippi | MEDICAID | 103810165 | |
| Mississippi | MEDICAID | 430653611 |
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