Provider Demographics
NPI:1174512446
Name:ECK, HEATHER C (MD)
Entity type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:C
Last Name:ECK
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:4135 BOARDMAN CANFIELD RD STE 101
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-9803
Mailing Address - Country:US
Mailing Address - Phone:330-286-5330
Mailing Address - Fax:330-286-5396
Practice Address - Street 1:8401 MARKET ST
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44512-6725
Practice Address - Country:US
Practice Address - Phone:330-729-2929
Practice Address - Fax:330-286-5396
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WY8691A207L00000X
OH35.084275207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
11670388OtherCAQH
OH2560992OtherMEDICAID
OHH295482OtherMEDICARE PTAN