Provider Demographics
NPI:1730181280
Name:HEIER, MARJORIE J (MD)
Entity type:Individual
Prefix:DR
First Name:MARJORIE
Middle Name:J
Last Name:HEIER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 NORTH BROADWELL
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803
Mailing Address - Country:US
Mailing Address - Phone:308-382-3660
Mailing Address - Fax:308-389-5111
Practice Address - Street 1:2201 NORTH BROADWELL
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803
Practice Address - Country:US
Practice Address - Phone:308-382-3660
Practice Address - Fax:308-389-5111
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE17444174400000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE34236OtherBLUE CROSS BLUE SHIELD NE
NE275491Medicare ID - Type Unspecified
NEE28313Medicare UPIN