Healthcare Provider Details

I. General information

NPI: 1427008119
Provider Name (Legal Business Name): PETER A ERHARDT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 05/21/2024
Certification Date: 05/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1835 E HIGH ST STE 2
SPRINGFIELD OH
45505-1276
US

IV. Provider business mailing address

1835 E HIGH ST STE 2
SPRINGFIELD OH
45505-1276
US

V. Phone/Fax

Practice location:
  • Phone: 373-228-9779
  • Fax: 937-322-5837
Mailing address:
  • Phone: 937-322-8977
  • Fax: 937-322-5837

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number35041542
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35041542E
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: