Basic Information
| Provider Information | |||||||||
| NPI: | 1265439954 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HEAPE | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | E | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 11407 | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352460100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8883135258 | ||||||||
| FaxNumber: | 2053135298 | ||||||||
| Practice Location | |||||||||
| Address1: | 298 MEMORAL DRIVE | ||||||||
| Address2: | OCONEE MEMORIAL HOSPITAL | ||||||||
| City: | SENECA | ||||||||
| State: | SC | ||||||||
| PostalCode: | 29672 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8883135258 | ||||||||
| FaxNumber: | 2053135298 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2005 | ||||||||
| LastUpdateDate: | 05/25/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/25/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 32170 | SC | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | G34360 | 01 | SC | SOUTH CAROLINA MEDICAID # | OTHER | 27499 | 01 | FL | BCBSF GRP# 98513 | OTHER | 253093700 | 05 | FL | MEDICAID | 606478700 | 01 | FL | DOL GRP# | OTHER | G34360 | 05 | SC | MEDICAID | 32170 | 01 | SC | SOUTH CAROLINA MEDICAL LICENSE | OTHER |