Eric Evan Petterson in Mahanoy City - Addiction Medicine
Eric Evan Petterson - NPI 1245269547
Eric Evan Petterson is a Addiction Medicine in Mahanoy City, Pennsylvania. Eric Evan Petterson practices all healthcare services and medical treatments related to Addiction Medicine. The NPI Number for Eric Evan Petterson is 1245269547. The last update date is 2023-11-11.
Eric Evan Petterson's current location address is 411 W Pine St, Mahanoy City, Pennsylvania. You can contact this provider via phone number 5704621040 and fax number 5704621042. The mailing address for Eric Evan Petterson is 411 W Pine St, Mahanoy City, Pennsylvania. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Eric Evan Petterson |
|---|---|
| Address | 411 W Pine St, Mahanoy City, Pennsylvania |
| Phone Number | 5704621040 |
| Fax Number | 5704621042 |
| Sole Proprietor | Y |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1245269547 |
|---|---|
| Provider Enumeration Date | 2006-07-01 |
| Last Updated Date | 2023-11-11 |
Provider Mailing Address Detail
| Address | 411 W Pine St |
|---|---|
| City | Mahanoy City |
| State | Pennsylvania (PA) |
| Post Code | 179482515 |
| Phone Number | 5704621040 |
| Fax Number | 5704621042 |
Provider's Primary Taxonomy Detail
| Speciality | Addiction Medicine |
|---|---|
| Taxonomy | 207Ra0401X |
| Licence No | MD039636L |
|
Definition: An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualification |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 10036980010 | PA | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Eric Evan Petterson by the Centers for Medicare & Medicaid Services?
The Eric Evan Petterson has been assigned the NPI (National Provider Identifier) 1245269547 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you kindly provide the complete physical address where Eric Evan Petterson's facilities are geographically located?
The facilities of Eric Evan Petterson are physically situated at the following location: 411 W Pine St, Mahanoy City, PA, 179482515.
What is Eric Evan Petterson's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Eric Evan Petterson is Addiction Medicine, and the corresponding taxonomy classification code for this specialized field is 207Ra0401X.
When was the Eric Evan Petterson's 1245269547 issued?
The Eric Evan Petterson's 1245269547 was issued on 2006-07-01.
As of what date were the Eric Evan Petterson's details last updated?
The information pertaining to the Eric Evan Petterson, including its address, specialty, and other details, was most recently updated on 2023-11-11.