Basic Information
| Provider Information | |||||||||
| NPI: | 1003294265 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HEUER | ||||||||
| FirstName: | ALWIN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 300 LONG SHOALS RD APT 7J | ||||||||
| Address2: | |||||||||
| City: | ARDEN | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287047720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2057054425 | ||||||||
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| Practice Location | |||||||||
| Address1: | 300 LONG SHOALS RD APT 7J | ||||||||
| Address2: | |||||||||
| City: | ARDEN | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287047720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2057054425 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/08/2015 | ||||||||
| LastUpdateDate: | 10/09/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367500000X | 077829-23 | NH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Anesthetist, Certified Registered | 163W00000X | 695210 | NY | N | Nursing Service Providers | Registered Nurse |
No ID Information.