| Doctor Name: | DR. GREGORY MARK HEIDEMAN |
| NPI Number: | 1295820546 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 49522-020 |
| Business Practice Address: | 9601 Townline Rd Minocqua, WI - 545489099 |
| Business Phone Number: | 7153581000 |
| Business Fax Number: | |
| Mailing Address: | 1000 N Oak Ave, MARSHFIELD |
| State: | WI |
| Postal Code: | 544495703 |
| Phone Number: | 7153875511 |
| Fax Number: | |
| NPI Enumeration Date: | 10/03/2006 |
| NPI Last Update Date: | 07/06/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085R0202X |
| License Number: | 49522-020 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Diagnostic Radiology |
| Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |