Provider Demographics
NPI:1548234438
Name:HEINEN, VICTORIA R (MD)
Entity type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:R
Last Name:HEINEN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1350 E COUNTY LINE RD
Mailing Address - Street 2:SUITE I
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46227-0873
Mailing Address - Country:US
Mailing Address - Phone:317-887-7736
Mailing Address - Fax:317-887-7787
Practice Address - Street 1:824 HUNTINGTON AVE
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:IN
Practice Address - Zip Code:46792-9277
Practice Address - Country:US
Practice Address - Phone:260-375-2965
Practice Address - Fax:260-479-2992
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2021-05-27
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Provider Licenses
StateLicense IDTaxonomies
IN01036044A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN080192142OtherRAILROAD MEDICARE #
IN080192142OtherRAILROAD MEDICARE #
IND95363Medicare UPIN