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NPI Code Detail

MEDICARE: ER-DOC INC

MEDICARE: ER-DOC INC
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
1207P00000XEmergency Medicine PhysicianOH
2207PE0004XEmergency Medical Services (Emergency Medicine) PhysicianOH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1922092014
Entity Type Code : Organization
Provider Name (Legal Business Name) : ER-DOC INC
Provider Business Mailing Address
First Line : 2203 EAGLES NEST CIR
Second Line :
City : SANDUSKY
State : OH
Zip : 44870-7024
Country : US
Telephone Number : 419-625-1343
Fax Number :
Provider Business Practice Location Address
First Line : 1111 HAYES AVE
Second Line :
City : SANDUSKY
State : OH
Zip : 44870-3323
Country : US
Telephone Number : 419-626-7400
Fax Number :
Authorized Official
Title or Position : OFFICE MANAGER
Name : PAM NESGODA
Credential :
Telephone Number : 419-625-1343
Provider Enumeration Date : 09/06/2005
Last Update Date : 08/15/2013

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