Provider Demographics
NPI:1154396497
Name:HEILMAN, DORIS (MD)
Entity type:Individual
Prefix:DR
First Name:DORIS
Middle Name:
Last Name:HEILMAN
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 1:1626 30TH AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99701-7423
Mailing Address - Country:US
Mailing Address - Phone:907-479-7701
Mailing Address - Fax:907-479-7718
Practice Address - Street 1:1626 30TH AVE.
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-7423
Practice Address - Country:US
Practice Address - Phone:907-479-7701
Practice Address - Fax:907-479-7718
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1253207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD1253Medicaid
AH6525008OtherDEA NUMBER
AKC96883Medicare UPIN
AH6525008OtherDEA NUMBER
AK0361450001Medicare NSC