Provider Demographics
NPI:1487890265
Name:HEIMAN, MARY
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:
Last Name:HEIMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44539 STERLING HWY
Mailing Address - Street 2:SUITE 206
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669-7938
Mailing Address - Country:US
Mailing Address - Phone:907-262-9400
Mailing Address - Fax:907-262-9422
Practice Address - Street 1:600 BARROW ST
Practice Address - Street 2:SUITE 404
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99501-3631
Practice Address - Country:US
Practice Address - Phone:907-258-3498
Practice Address - Fax:907-279-0171
Is Sole Proprietor?:No
Enumeration Date:2008-12-26
Last Update Date:2008-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKCMPENDINGMedicaid