Provider Demographics
NPI:1306897061
Name:TOTH, HEATHER L (MD)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:L
Last Name:TOTH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:HEATHER
Other - Middle Name:L
Other - Last Name:FESTERLING
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9200 W WISCONSIN AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3522
Mailing Address - Country:US
Mailing Address - Phone:414-337-7050
Mailing Address - Fax:414-805-0988
Practice Address - Street 1:9200 W WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3522
Practice Address - Country:US
Practice Address - Phone:414-337-7050
Practice Address - Fax:414-805-0988
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI44878207R00000X, 2080A0000X, 208M00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1306897061Medicaid
007806261XOtherHUMANA
WI34628200Medicaid
I27298Medicare UPIN
WI34628200Medicaid