Heyerdahl, Dan L

Heyerdahl, Dan L is an sole proprietor health care provider with primary practice located at 2833 Clinton Terrace , Santa Barbara CA 93105. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Heyerdahl, Dan L can be contacted via phone (920) 850-8941.

Contact Information

Primary practice address
2833 Clinton Terrace Santa Barbara CA 93105
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 22397-020 Wisconsin

Profile Details

NPI number 1477549004
LBN Legal business name Heyerdahl, Dan L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 20th, 2005
Last updated Mar 4th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477549004 NPPES
Wisconsin MEDICAID 30410700

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