Clare B. Heidtke, MD, PLLC

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

CH045760 Issued in MI

Legal business name

CLARE B. HEIDTKE, MD, PLLC

Doing business as

Petoskey Gynecology & Infertility

Practice address

2810 Charlevoix Ave
Suite 104
Petoskey, MI 49770-8421

Phone

(231) 487-0970

Fax

(231) 487-0979

NPI assigned

Sep 9, 2008

Last updated

Sep 9, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Clare B Heidtke, M.D.NPI 1013004373

Title

Owner

Phone

(231) 487-0970

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Petoskey Gynecology & Infertility Doing business as

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Clare B Heidtke, M.D.

  • Gynecology Physician
  • Petoskey, MI
  • NPI 1013004373
  Authorized official Same address or phone
• Janet Talmo, MD

  • Family Medicine Physician
  • Petoskey, MI
  • NPI 1932152071
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1220918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220918400000",
    "number": "1396993895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 CHARLEVOIX AVE",
            "address_2": "SUITE 104",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497708421",
            "telephone_number": "231-487-0970",
            "fax_number": "231-487-0979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 CHARLEVOIX AVE",
            "address_2": "SUITE 104",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497708421",
            "telephone_number": "231-487-0970",
            "fax_number": "231-487-0979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARE B. HEIDTKE, MD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-09",
        "last_updated": "2008-09-09",
        "status": "A",
        "authorized_official_last_name": "HEIDTKE",
        "authorized_official_first_name": "CLARE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-487-0970",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "MI",
            "license": "CH045760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3509689",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Petoskey Gynecology & Infertility",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Andrea Cherry, LMSW
• Chiropractic Center of Petoskey PC
• Jared Chojnacki
• Christine Kidder D.O. P.L.L.C
• Kelsi Lynn Churchill
• Julie Kathleen Clark, M.S., LPC, CRC, MITS
• Molly Ann Clark, AUD
• Clear the Dermatology Clinic PC
• Jenny M Clement, LLCP
• Kara E Cockfield, MD

• Gynecology Physician in Petoskey, MI
• Providers in Petoskey, MI by specialty
• Gynecology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.