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DR. HEIDI FRUTCHY DEBLOCK M.D.

Physicians Internal Medicine Critical Care Medicine

Provider NPI: 1922095892

Provider Information:
DR. HEIDI FRUTCHY DEBLOCK M.D.
Gender: F
Sole Proprietor

Practice Location:
22 BRAMHALL ST  PORTLAND, ME 04102-3175 US
Tel: 207-662-4618  Fax: --

Business Mailing Address:
22 BRAMHALL ST  PORTLAND, ME 04102-3175 US
Tel: 207-662-4618  Fax: --

NPI Information:
NPI: 1922095892
Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N207RC0200XPhysicians
Internal Medicine
Critical Care Medicine
MEMD22762
N207RC0200XPhysicians
Internal Medicine
NY188769
Y208M00000XPhysicians
Hospitalist
MEMD22762

Other Provider Identifiers:

IssuerNumberStateType
01583788NY05



American Medical Association 2012 taxonomy code information

Code: 208M00000X

Type:

Classification:



Definition:



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