Provider Demographics
NPI:1962782318
Name:HEYDT, STUART NONE (MD)
Entity type:Individual
Prefix:DR
First Name:STUART
Middle Name:NONE
Last Name:HEYDT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:544 OLDE COURSE RD
Mailing Address - Street 2:
Mailing Address - City:HERSHEY
Mailing Address - State:PA
Mailing Address - Zip Code:17033-1337
Mailing Address - Country:US
Mailing Address - Phone:717-534-0864
Mailing Address - Fax:717-533-8695
Practice Address - Street 1:544 OLDE COURSE RD
Practice Address - Street 2:
Practice Address - City:HERSHEY
Practice Address - State:PA
Practice Address - Zip Code:17033-1337
Practice Address - Country:US
Practice Address - Phone:717-534-0864
Practice Address - Fax:717-533-8695
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-17
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD014798E204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery