Provider Demographics
NPI:1730685413
Name:HEINZE, ADAM KENNETH (MD)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:KENNETH
Last Name:HEINZE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7950 N PORT WASHINGTON RD
Mailing Address - Street 2:
Mailing Address - City:FOX POINT
Mailing Address - State:WI
Mailing Address - Zip Code:53217-3131
Mailing Address - Country:US
Mailing Address - Phone:414-253-1194
Mailing Address - Fax:414-540-1065
Practice Address - Street 1:7950 N PORT WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:FOX POINT
Practice Address - State:WI
Practice Address - Zip Code:53217-3131
Practice Address - Country:US
Practice Address - Phone:414-253-1194
Practice Address - Fax:414-540-1065
Is Sole Proprietor?:No
Enumeration Date:2018-04-02
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI74117208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics