Provider Demographics
NPI:1316977788
Name:HEYMAN, EUGENE H (MD)
Entity type:Individual
Prefix:
First Name:EUGENE
Middle Name:H
Last Name:HEYMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 ELM ST
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-6502
Mailing Address - Country:US
Mailing Address - Phone:413-442-1019
Mailing Address - Fax:413-447-8521
Practice Address - Street 1:20 ELM ST
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-6502
Practice Address - Country:US
Practice Address - Phone:413-442-1019
Practice Address - Fax:413-447-8521
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA42547207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2062607Medicaid
MA2062607Medicaid
080013873Medicare PIN
A56050Medicare UPIN