Provider Demographics
NPI:1053366153
Name:HEIM, HEIDI H (DC)
Entity type:Individual
Prefix:DR
First Name:HEIDI
Middle Name:H
Last Name:HEIM
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 2ND AVE SW
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:ND
Mailing Address - Zip Code:58401-4104
Mailing Address - Country:US
Mailing Address - Phone:701-251-1550
Mailing Address - Fax:701-952-1504
Practice Address - Street 1:102 2ND AVE SW
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:ND
Practice Address - Zip Code:58401-4104
Practice Address - Country:US
Practice Address - Phone:701-251-1550
Practice Address - Fax:701-952-1504
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2010-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND580111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND18312Medicaid
350035456OtherRAILROAD MEDICARE
ND12861OtherNORTH DAKOTA BLUE SHIELD
NDN12861Medicare ID - Type Unspecified
ND18312Medicaid