Provider Demographics
NPI:1467444596
Name:HEISE, CAROLINE RUTH (MD)
Entity type:Individual
Prefix:DR
First Name:CAROLINE
Middle Name:RUTH
Last Name:HEISE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1456 FERRY RD
Mailing Address - Street 2:SUITE 402
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-3529
Mailing Address - Country:US
Mailing Address - Phone:215-348-2992
Mailing Address - Fax:215-348-2052
Practice Address - Street 1:1456 FERRY RD
Practice Address - Street 2:SUITE 402
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2391
Practice Address - Country:US
Practice Address - Phone:215-348-2992
Practice Address - Fax:215-348-2052
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD069719L207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0017826350004Medicaid
PA0017826350004Medicaid
034374S4ZMedicare ID - Type Unspecified