Provider Demographics
NPI:1902493844
Name:POPOWITZ, HEATHER N (PA-C)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:N
Last Name:POPOWITZ
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8020 WINONA AVE
Mailing Address - Street 2:
Mailing Address - City:ALLEN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48101-2228
Mailing Address - Country:US
Mailing Address - Phone:313-806-6585
Mailing Address - Fax:
Practice Address - Street 1:8020 WINONA AVE
Practice Address - Street 2:
Practice Address - City:ALLEN PARK
Practice Address - State:MI
Practice Address - Zip Code:48101-2228
Practice Address - Country:US
Practice Address - Phone:313-806-6585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-27
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant