MEDICARE: ERIC CHRISTOPHER WILKERSON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	35.131552	OH
2	207ND0101X	MOHS-Micrographic Surgery Physician	35.131552	OH
3	207ND0101X	MOHS-Micrographic Surgery Physician	ME134777	FL
4	207N00000X	Dermatology Physician	ME134777	FL

General Provider Information

NPI Number	:	1841556396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC CHRISTOPHER WILKERSON MD

Provider Business Mailing Address
First Line	:	2021 E COMMERCIAL BLVD STE 301
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-3754
Country	:	US
Telephone Number	:	954-546-3376
Fax Number	:

Provider Business Practice Location Address
First Line	:	2021 E COMMERCIAL BLVD STE 301
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33308-3754
Country	:	US
Telephone Number	:	954-546-3376
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/10/2012
Last Update Date	:	02/10/2020

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