1144428160

Everything you always wanted to know about DR. SANTRY P HEENA MD 1 DR. PATEL PRAVIN HEENA MD but were afraid to ask.

DR. SANTRY P HEENA MD 1 DR. PATEL PRAVIN HEENA MD

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Provider Prefix Provider Last Name Provider Middle Name Provider First Name Provider Credential Provider Other Name Type Code Provider Other Name Prefix Provider Other Last Name Provider Other Middle Name Provider Other First Name Provider Other Credential
DR. SANTRY P HEENA MD 1 DR. PATEL PRAVIN HEENA MD
Gender:
Female
Enumeration date:
2007-07-11
Last update date:
2017-08-18
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
Yes
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Identifiers

identifier description issuer state
110081745A Medicaid none MA
001002701 Medicare PIN none MA

Taxonomies

Taxonomy State License Number Primary?
2086S0102X Surgical Critical Care OH 35131903 Y
2086S0127X Trauma Surgery MA 234718 N

Phone Numbers

Type Number
Practice Location Address Telephone Number 6142932101
Mailing Address Fax Number 6142939155
Practice Location Address Fax Number 6142939155
Mailing Address Telephone Number (614) 293-2101

Addresses

Type Address City State Postal Country
Mailing Address 700 ACKERMAN RD STE 570 COLUMBUS OH 43202 OH
Practice Location Address 1581 DODD DR COLUMBUS OH 43210 OH

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