Healthcare Provider Details

I. General information

NPI: 1962409748
Provider Name (Legal Business Name): ERIC C TROYER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 09/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 S CENTRAL AVE
LANDIS NC
28088-1402
US

IV. Provider business mailing address

107 S CENTRAL AVE
LANDIS NC
28088-1402
US

V. Phone/Fax

Practice location:
  • Phone: 704-855-2101
  • Fax: 704-855-2105
Mailing address:
  • Phone: 704-855-2101
  • Fax: 704-855-2105

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number9500748
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: