| Doctor Name: | CLARE B HEIDTKE |
| NPI Number: | 1013004373 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | CH045760 |
| Business Practice Address: | 2810 Charlevoix Ave Suite 104 Petoskey, MI - 497708421 |
| Business Phone Number: | 2314870970 |
| Business Fax Number: | 2314870979 |
| Mailing Address: | 2810 Charlevoix Ave, Suite 104 PETOSKEY |
| State: | MI |
| Postal Code: | 497708421 |
| Phone Number: | 2314870970 |
| Fax Number: | 2314870979 |
| NPI Enumeration Date: | 10/06/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207VG0400X |
| License Number: | CH045760 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Obstetrics & Gynecology |
| Taxonomy Specialization: | Gynecology |
| Taxonomy Definition: | |