Provider Demographics
NPI:1154390037
Name:WEHRHEIM, HEIDI M (MD)
Entity type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:M
Last Name:WEHRHEIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1340 HAL GREER BLVD
Mailing Address - Street 2:ATTN: TAMMIE SILVA
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-3800
Mailing Address - Country:US
Mailing Address - Phone:304-399-6727
Mailing Address - Fax:304-399-6726
Practice Address - Street 1:1340 HAL GREER BLVD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-3800
Practice Address - Country:US
Practice Address - Phone:304-399-6727
Practice Address - Fax:304-399-6726
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV21151207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV7930591OtherAETNA
WV3810000052Medicaid
WV001720367OtherMS BCBS
WV3810000052Medicaid
WV7930591OtherAETNA
WV2027825Medicare PIN
WV2027821Medicare PIN
WV2027824Medicare PIN
WVI07050Medicare UPIN