Male or Other

Paul P. Heideman M.D.

Vascular & Interventional Radiology Physician in Burlington, WI(View on Map)

Full Name

Paul P Heideman M.D.

NPI Number

1144546870

NPI Type

Individual Provider

Gender

Male

Enumeration Date

04/20/2010

Specialties

(Taxonomies)

Code

2085R0204X
2085R0202X

Primary Taxonomy

Yes
No

Licenses

State

Wisconsin

License Number

63817

Contact
Information

Purpose

Mailing
Location

Address

PO BOX 735044
252 MCHENRY ST

City

Chicago
Burlington

State

IL
WI

Postal Code

60673-5044
53105

Country

US
US

Telephone Number

N/A
(262) 767-6100

Identifiers

Identifier

ENROLLED
ENROLLED
ENROLLED

Identifier State

WI
IA
MN

Identifier Issuer

Unknown
Unknown
Unknown

Health Information Exchange

Endpoint Type

FHIR
DIRECT

Endpoint

https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/
pheideman178325@direct.myadvocateaurora.org

Endpoint Description

Unknown
Unknown

Use

Unknown
Direct

Content Type

Unknown
Unknown

Affiliation

N
N

Endpoint Location

252 McHenry StBurlington, WI53105US
252 McHenry StBurlington, WI53105US

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 08/10/2023

Provider Address